Daijiworld Media Network - Mumbai

Mumbai, Feb 25: Stroke, long considered a disease of the elderly, is increasingly affecting younger Indians, according to the latest analysis from the ICMR-led National Stroke Registry Programme.

The registry, which analysed nearly 35,000 stroke cases from 30 hospitals between 2020 and 2022, reveals that 13.8% of stroke patients in India are below 45 years of age — roughly one in seven cases. With a mean patient age of 59 years, the findings mark a worrying epidemiological shift and signal an emerging public health challenge.

The data also exposes serious gaps in acute stroke care. Only about 20% of patients reached hospitals within the crucial 4.5-hour therapeutic window, limiting access to time-sensitive treatments such as thrombolysis and mechanical thrombectomy. Alarmingly, nearly 40% arrived more than 24 hours after symptom onset.

As highlighted by the World Health Organization, stroke is a medical emergency where rapid response is vital. The widely promoted FAST acronym — Face drooping, Arm weakness, Speech difficulty, Time to call emergency services — remains central to early recognition.

Delayed hospital arrival significantly increases the likelihood of death or long-term disability. Registry data indicates that more than half of patients experience death or significant disability within three months of a stroke.

1. Hypertension and Metabolic Disorders

High blood pressure remains the most dominant risk factor, affecting nearly three-quarters of stroke patients across age groups. Diabetes, smoking, smokeless tobacco use and alcohol consumption are also major contributors.

Urbanisation, sedentary lifestyles, processed diets and rising stress levels have led to increased prevalence of hypertension, dyslipidemia and metabolic syndrome among young adults — conditions once associated primarily with ageing.

2. Lifestyle and Stress Factors

Medical experts link young-onset strokes to irregular sleep cycles, high-stress work environments and prolonged sedentary habits. Increasing numbers of professionals in their 30s and 40s are now presenting with stroke symptoms, a demographic previously considered low-risk.

3. Emerging and Region-Specific Causes

Beyond traditional cardiovascular risks, conditions such as sleep apnoea, obesity and cardioembolic disorders are gaining attention. Sleep apnoea, in particular, causes intermittent oxygen deprivation, straining blood vessels and elevating stroke risk.

In certain Indian regions, rare vascular conditions like Takayasu’s arteritis, cerebral venous thrombosis and inherited coagulation disorders show relatively higher incidence among younger patients compared to Western populations.

Prevention and the Way Forward

Global health agencies, including the Centers for Disease Control and Prevention, emphasise that stroke prevention is largely achievable through sustained lifestyle and medical interventions.

Key measures include:

• Blood pressure control: Regular screening, medication adherence and lifestyle modification.

• Healthy living: Balanced diet, physical activity, adequate sleep and avoiding tobacco and excessive alcohol.

• Diabetes and cholesterol management: Early diagnosis and strict control to prevent vascular damage.

• Public awareness: Recognising warning signs and seeking immediate medical attention.

The registry’s findings underscore that stroke is no longer confined to older age groups in India. As patterns evolve, healthcare systems must strengthen emergency response infrastructure, especially in semi-urban and rural areas, while policymakers intensify preventive campaigns targeting young adults.

Stroke is increasingly treatable when detected early — but prevention remains the most powerful defence. Protecting India’s productive young population will require a coordinated effort spanning individuals, clinicians and public health systems alike.