
American Academy of Neurology / Neurology · 16 Oct 2026 · Research
In one US region, first strokes at ages 20 to 54 rose from 33.9 to 62.2 per 100,000 between 1993 and 2020
Study (population surveillance, one region). Emily R. Fisher at the University of Cincinnati and colleagues report in Neurology, published 23 Sep 2026 (DOI 10.1212/WNL.0000000000218622), on Greater Cincinnati and Northern Kentucky. They counted 2,076 first strokes in adults ages 20 to 54 from 1993 to 2020. The rate rose from 33.9 to 62.2 cases per 100,000 person-years, about an 83 percent increase. Ischemic stroke, a blocked vessel, rose from 23.8 to 47.3 and accounted for most of the change. Bleeding strokes did not show a comparable rise. Among people who had a stroke, high blood pressure, diabetes, atrial fibrillation, and substance use became more common; documented substance use rose from 4.6 percent to 40.2 percent, much of it cannabis. There was no comparison group without stroke, so the paper cannot show that those factors caused the rise. Thirty-day death fell from 11.7 percent to 9.4 percent after accounting for age, race, and sex. The pattern is local, not a national rate. Not medical advice.
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- Under 40
- 40–59
- Cardiovascular / lipids
- Metabolic / glucose
- stroke
- ischemic
- surveillance
- study










