Strokes striking more young people

• Rates of stroke increased among younger people over a 10-year period.
• Men and women were affected but not at the same ages.

Gary Vanderwall didn’t win the lottery, but friends acted like he hit a million-to-one shot.

“They thought it was a crazy one-off thing that happened,” the 35-year-old said after he told them he’d had a stroke. “Everybody was amazed. They said there’s no way.”

The episode happened on Memorial Day last year, and Vanderwall was in the hospital for two months. He returned to work in January and said he still walks with a slight limp.

He admitted he ignored his high blood pressure and practiced some unhealthy eating habits. He said both may have contributed to the strokes, but friends weren’t scared straight.

“They didn’t look at that like a lesson at all,” said the Palmyra, Wayne County, resident.

Yet their number also could come up.

More 18- to 54-year-olds are being hospitalized for strokes, according to local data over a 10-year span. The statistics mirror a national trend that also showed an increase in risk factors over the same time.

Doctors aren’t ruling out the rare causes such as a heart defect, a clotting disorder or a ruptured artery in young patients. But increasingly they are seeing the hypertension, high cholesterol, diabetes, tobacco use and obesity in 30-, 40- and 50-year-olds that are common causes of stroke in their parents.

“We see people who come in with a stroke and they say, ‘I haven’t seen the doctor in 10 years. I felt fine. I didn’t think there was anything wrong with me,’” said Dr. Kelly Matmati, stroke program director at Rochester General Hospital. “And then we find out it looks like you’ve had high blood pressure for many years, you’re starting to develop signs of diabetes and may even be starting to develop heart disease and not even know it.”

No energy, no appetite

Vanderwall, who works for a fiber optics and telecommunications company, had been out of state for two weeks on a job that had him working nights.

He felt bad all weekend after he came back. At his family’s Memorial Day cookout, he shrugged off his lack of appetite for his mother’s potato salad as carryover from the 14-hour drive home.

“All I wanted to do was lay down,” he recalled.

He was still on the couch that night, watching TV. He got up to go to the bathroom and fell over.

“My left side wasn’t working at all,” he said.

He was alert the whole time, said he didn’t have any pain and was able to talk.

“I was scared to death,” he said. “I didn’t know what was going on.”

The EMTs in the ambulance told him they first thought Vanderwall was having a seizure because he was so young. Then they did some tests. “’Yeah, you’re having a stroke,’” they said.

Vanderwall said he knew the top number of his blood pressure was in the 160-170 range but never did anything about it.

“I was, ‘I feel fine.’”

Not just for old people

Two-thirds of strokes occur in people older than 65, said Dr. Curtis Benesch, medical director of the UR Medicine Comprehensive Stroke Center. “Which still means fully one-third of them happen in what people think of as middle age, if not younger. It’s not a disease that’s waiting for you when you’re 90.”

Yet convincing young adults is a tough sell, said Rev. Phyllis Jackson, founder of the Interdenominational Health Ministry. The organization trains laypeople to bring health messages to places of worship.

“They hear ‘stroke,’ most young people never associate that with them, ever, ever, ever,” says Jackson, also a registered nurse.

“When I’m talking to young guys with high blood pressure, I always say, if you don’t get this under control, you’re going to have a stroke and you’re not going to die. You’re going to be here and somebody’s going to have to take care of you. That gets their attention because they don’t want that … that they’ll be incapacitated.”

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In data comparing 2003-2004 to 2011-2012 in the nine-county Finger Lakes region, the rate of stroke increased dramatically per 100,000 population some age groups, according to Common Ground Health.

• The largest increase was among 45- to 54-year-olds. Rates went up 43 percent over the decade.
• Stroke in the 18-to-34 age group went up 36 percent. The lowest increase was in the 55-to-64 group, which had a 12 percent increase.
• Rates among men ages 45 to 54 increased 47 percent. Vanderwall’s age group, the 35- to 44- year-olds, had an 11 percent increase.
• Rates among 35- to 44-year-old women increased 46 percent and in the 45- to 54-year-old group, the rate went up 38 percent. The local data did not parse the risk factors.
• Among Hispanics, the rate increased 136 percent in the 45-54 age group. Among black non-Latinos, cases declined only among 35- to 44- year-olds.

“As startlingly as the upward trend in the younger demographics, is that within those demographics there are increases that are particularly striking in the Hispanic and male populations even beyond the trend, which is concerning,” said Albert Blankley, director of research and analytics for Common Ground Health.

Downplaying danger

While it’s difficult to equate local with national data, the rates are in line with a study in JAMA Neurology published online in April. That report also assessed risk factors such as high blood pressure, diabetes, high cholesterol, tobacco use and obesity — and found more people who had a stroke had multiple conditions.

The study did not account for family history, and the authors said increased hospitalization was not likely due only to more frequent use of MRI or CT scans. They said the increased number of strokes should be a wake-up call that young adults are suffering from a largely preventable disease.

“I think there’s an educational gap on the part of the public about how important high blood pressure is,” said Dr. Adam Kelly, stroke neurologist for UR Medicine at Strong Memorial and Highland hospitals. “Even borderline (high) blood pressure. If people stay at that stage for many, many years, then that does take a toll.”

Because the risk factors are stealthy and there's little awareness of stroke in younger people, the tendency is to downplay any immediate danger.

“Even if the condition is addressed 10, 20, 30 years down the road, some of the damage probably has been done,” Kelly said. “The importance of intervening with these treatable risk factors early has a huge potential benefit.”

PSINGER@Gannett.com

What is stroke?

Stroke happens when a blood vessel to the brain or in the brain is blocked by a clot or breaks open.

Stroke is most common in people older than 60, but increasingly younger adults are having strokes.

Signs of a stroke include trouble walking, speaking and understanding, and numbness of the face (one side may droop), arm or leg.

Stroke is a medical emergency and you should call 911.