Data on 2,076 first-ever strokes showed incidence among adults ages 20–54 in Greater Cincinnati/Northern Kentucky rose from about 34 to 62 per 100,000 people a year between 1993–94 and 2020, mainly due to ischemic strokes; rates fell among older adults.
Among younger adults who had strokes, hypertension, diabetes, atrial fibrillation and substance use became more common. Documented substance use rose from 4.6% to 40.2%, primarily marijuana. Co-author David J. Robinson said researchers cannot establish whether marijuana contributed; much of the evidence linking it to stroke concerns heavier use.
The share of younger stroke patients who died within 30 days fell from 11.7% to 9.4%, primarily in bleeding-related strokes. Researchers said the study could not determine why incidence rose: it lacked comparable risk-factor data for people without strokes, covered five counties, and changes in diagnostic methods and documentation, including MRI use, may have affected the findings.
