If you thought strokes were just something that happened to elderly people, think again – the number of middle-aged people suffering attacks has rocketed.
In the last 15 years, the number of men aged 40-54 being hospitalised with the condition has risen by 46%, while for women in the same age bracket, rates are up 30%, according to figures released by the Stroke Association for the current Action On Stroke Month.
Overall, the number of strokes occurring in people of working age (20-64) has increased by a quarter.
“These figures show that stroke can no longer be seen as a disease of older people,” says Jon Barrick, chief executive of the Stroke Association.
“There is an alarming increase in the numbers of people having a stroke in working age. This comes at a huge cost, not only to the individual, but also to their families and to health and social care services.
“We must do more to raise people’s awareness of risk factors.”
WHAT IS STROKE?
A stroke is a ‘brain attack’ which happens when blood supply to the brain is cut off, either by a clot (ischaemic stroke; accounting for around 85% of annual UK cases) or brain bleed (haemorrhagic; accounting for around 15% of cases).
Symptoms usually occur suddenly, and can include weakness or numbness on one side of the body, difficulty finding words, blurred vision or loss of sight.
There are around 152,000 strokes a year in the UK, and it’s the leading cause of complex disability, as severe strokes can leave people paralysed and unable to communicate.
It’s also one of the leading causes of death – the Stroke Association says around half of people who have a haemorrhagic stroke die before they get to hospital.
Another type of stroke is a transient ischaemic attack (TIA), sometimes called a mini-stroke, which has similar symptoms but they are less severe and temporary, often lasting from a few minutes to an hour. They should never be ignored though, as around 15% of ischaemic strokes are preceded by a TIA.
ARE UNHEALTHY LIFESTYLES TO BLAME?
Andrew Marr’s stroke back in January 2013 highlighted how younger people can be affected. The broadcaster, who was 53 at the time, faced a long recovery, learning to walk and talk again.
His was reportedly caused by a torn artery, brought on by vigorous exercise – but cases like this are uncommon, and experts believe that lifestyle factors are mostly to blame for the increase in middle-aged strokes.
Lack of exercise, smoking, drinking too much alcohol, being overweight and an unhealthy diet are all known to raise the risk. These things can cause blood vessel damage, increase blood pressure and make blood more likely to clot – all potential factors in stroke.
Dr Dale Webb, Stroke Association’s research and information director, notes that the single biggest risk factor is high blood pressure – it’s estimated that half of strokes could be avoided if blood pressure was well controlled.
“Lifestyle factors have a significant role to play,” he stresses. “We’re all told to have our five-a-day fruit and veg, and part of the reason for that is that fruit and vegetables are very high in potassium and vitamins A and C, and they help reduce blood pressure.
“In fact, higher amounts of fruit and veg could lower your risk of stroke by about 30%, which is really significant.”
However, only 15% of the UK population eat the recommended five-a-day.
Too much salt can cause high blood pressure too, so reducing dietary salt can help reduce the risk. Alcohol can also affect blood pressure, and smoking doubles the risk of dying from a stroke, adds Dr Webb. But, he points out: “The good news is that you can do fairly modest things that will reduce your risk.”
OTHER CONCERNS
Certain medical conditions, including diabetes, atrial fibrillation (AF, a serious form of arrhythmia) and high cholesterol, can also increase stroke risk, so finding out if you have such conditions – and managing them well – can help.
Some risk factors, however, can’t be avoided. While there are increasing numbers of middle-aged stroke victims in hospitals, the largest number of people who have strokes are still aged over 55, as the risk increases as you get older and arteries become narrower and harder. Family history can also put you at higher risk of stroke.
“Either people see stroke as an inevitable part of ageing, or, as we know from research, a large proportion of people in the 35-54 age range think a stroke will never happen to them,” says Dr Webb.
“But we know a stroke can happen at any age, and it can be treated, especially if you get to hospital quickly. The critical factor is time.”
MEDICAL EMERGENCY
If a stroke is suspected, getting to hospital immediately is vital.
For people with strokes caused by a blood clot, a treatment called thrombolysis can be given to break down the clot – but it’s only effective up to four-and-a-half hours after it strikes.
“So if you suspect a stroke, don’t call your GP, call 999 and get straight into hospital. The sooner you get there, the more chance there is of having this treatment if necessary,” advises Dr Webb.
Dr Ajay Bhalla, a consultant stroke physician at London’s St Thomas’ Hospital, agrees that urgent medical care is vital, and points out that three months after a stroke, around 30% of patients will make a good recovery, 30% will remain disabled and 30% won’t survive.
“The effects of the stroke are driven by the extent of brain injury, the type of stroke and the age of the patient, but also by the treatments a stroke patient should receive,” he explains.
“The best survival for patients are those that receive stroke unit care in hospital, including specialist consultant assessment, expert nursing care [including early hydration and nutrition] and timely therapy assessment.”
He adds: “Stroke in any age group can be completely devastating, and the focus needs to be prioritised around prevention.”
WOULD YOU SPOT THE SIGNS?
When a stroke strikes, acting fast can save lives, and help prevent long-term serious disability. The FAST test can help you recognise some of the most common symptoms:
Facial weakness: Can the person smile? Has their face fallen on one side?
Arm weakness: Can the person raise both arms and keep them there?
Speech problems: Can the person speak clearly and understand what you say? Is their speech slurred?
Time to call 999.
For more information, visit www.stroke.org.uk or call the Stroke Association helpline on 0303 303 3100