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Schlaganfallrisiko bei jungen und mittleren Erwachsenen

von NFI Redaktion

It was a hot July day in Nashville. Sekou Writes, a 51-year-old writer from New York, had just given a speech at a graduation ceremony for a summer program he directed for teenagers. He stepped down from the podium when everything froze.

„I dropped the [paper] program I had just delivered,“ Writes says. „I reached for it, but I couldn’t reach it. I was just stuck there.“

The next thing he remembers was hands on his back, but he couldn’t turn around to see who was holding him.
„From that moment on, it was just snippets of things I saw, then I woke up in a place with a cot and didn’t know who the people around me were,“ Writes says. „My language centers didn’t seem to be functioning. My arm didn’t seem to be working. It was unsettling.“ He later learned that he had suffered a hemorrhagic stroke.
(There are two types of strokes. Hemorrhagic strokes involve bleeding in the brain. Ischemic strokes, which are more common, are caused by blood clots.)

When you hear of someone having a stroke, you probably envision someone much older – maybe in their 70s or older – with other medical issues that seem to be more common with age. Someone like Writes, who exercises regularly and has no medical warnings, probably isn’t who you think would have a stroke.

However, new research shows that strokes in young adults and those in middle age, like Writes, are on the rise. According to the American Heart Association, the number of a specific type of bleeding stroke, called intracerebral hemorrhage (ICH), has increased by 11% in the past decade.

Why is this happening? And what can be done to stop this trend?

When Writes suffered his stroke, he was on the 409th day of his solo challenge to run at least 1 mile every day, regardless of weather, location, or mood.

He had started his running streak in June 2021 on his birthday. The plan was to see if he could run at least one mile every day for a month. The next month, he expanded his one-man race and broadened the mission to include fundraising efforts, donating the money to various causes and groups supporting the homeless.

„It grew every month, a new mission, a new person I gave the money to,“ Writes says. „I ran in 25 different cities and raised over $7,000.“

However, the charitable running streak ended abruptly, at least temporarily, when he suffered his stroke.

„While race, gender, and genetic predisposition contribute to some of these ICH stroke cases, by far, the most common risk factors are lifestyle,“ says Dr. Chirag Gandhi, Director of the Brain and Spine Institute at Westchester Medical Center in New York.

When it comes to both ischemic and ICH strokes, high blood pressure, diabetes, smoking, obesity, and lack of physical activity increase your risk, regardless of whether you are of middle or older age, he says. Your risk is higher if you lack access to good medical care.

The rise in hypertension or high blood pressure in young adults should be a focus, says Dr. John H. Hanna, Vascular Neurologist and Medical Director of the Comprehensive Stroke Center at the Atlantic Health System’s Overlook Medical Center in Summit, New Jersey.

Data link high blood pressure to stroke frequency in young people, says Dr. Christina Johns, Pediatric Emergency Physician and Senior Medical Advisor at PM Pediatric Care in Annapolis, MD. „This is exacerbated by obesity, poor nutrition, and smoking,“ she says. Even though it’s not definitively proven, a more sedentary lifestyle, „particularly with more screen time during remote work-from-home measures during the pandemic, could contribute to this increase,“ she says.

The number of strokes in younger people was already increasing before COVID-19. But „in some cases, strokes have been reported as a consequence of severe COVID infection,“ says Hanna. Since the COVID-19 virus is still relatively new, there is no long-term data yet to support the connection.

However, scientists know that COVID-19 „causes a diffuse cascade of inflammation in the body affecting multiple organ systems,“ says Gandhi. And sometimes, this cascade leads to blood clots that can cause a stroke, he says.

Good news is that the lifestyle risk factors that increase the risk of stroke are not set in stone. You can take steps to prevent a stroke. Small but meaningful changes to your daily habits can make a difference.

You can change your lifestyle by incorporating healthier choices into your diet – such as limiting fatty foods and not consuming too much alcohol – and getting more physical activity, such as targeted daily walks, says Gandhi. „Also, close communication with a doctor for preventive check-ups, routine examinations, and potentially initiating medication when needed can be helpful.“ These are all helpful and simple adjustments.

Your doctor can assess your stroke risk and provide specific recommendations to reduce this risk.

As for Writes, he is working with physical therapists to improve his mobility, speech, and memory. He stayed on track with running and is now particularly mindful of staying adequately hydrated. Although fluid intake is not an official part of stroke recovery, it supports his body during his demanding endurance activities.

Writes walked and ran the entire 26.2 miles at the New York City Marathon 2022 and proudly crossed the finish line.

You don’t have to become a marathon runner to reduce your stroke risk. All of your positive changes add up over time.

„I’ve changed, and that change is still evident,“ Says Writes about his life after his stroke. „I try to go with the flow, focusing on improving myself by 1% every day.“

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