Marijuana use among young stroke patients climbed from under 1 per cent to more than 30 per cent in under three decades, a study in the journal Neurology found. Rates in adults aged 20 to 54 nearly doubled over the same period, while older adults' rates fell.

The study drew on a registry covering the Greater Cincinnati and Northern Kentucky region. Cases climbed from about 34 per 100,000 people in 1993-94 to roughly 62 per 100,000 by 2020.

'It's not a question that is going away. It's not a problem that's getting better,' said Michelle Leppert, a vascular neurologist at Tufts Medical Center.

David Robinson, a University of Cincinnati neurologist and study author, said similar risk factors have also risen among older adults, whose rates have not climbed. 'It might be part of the story, but I don't think it's the entire story,' he said.

Ischaemic strokes, caused by blocked blood flow, drove most of the rise. These strokes nearly doubled among younger adults over the study period.

The analysis included 2,076 first-time strokes recorded over the study period. Black individuals accounted for 35.6 per cent of cases, and women made up 49.6 per cent.

Risk Factors Climb Sharply

Traditional risk factors surged among younger patients. High blood pressure rose from 47 per cent to 60 per cent, diabetes from 19 per cent to 26 per cent, and atrial fibrillation from 1 per cent to 6 per cent.

Substance use saw the sharpest rise of all, climbing from under 5 per cent of patients in 1993-94 to 40 per cent by 2020. Much of that increase was driven by marijuana.

Robinson said its use has increased dramatically, even though the downstream effects remain unclear. He said marijuana's link to cardiovascular disease deserves closer study.

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Doctors Urge Early Screening

Robinson said many young adults lack a regular doctor, so risk factors often go undetected. He pointed to the American Heart Association's 'Life's Essential Eight' guidance on diet, sleep and tobacco use.

Christopher Anderson, chief of the stroke division at Mass General Brigham, said the study's population reflects the wider US. He was not involved in the research but said the findings likely apply nationally.

Leppert said stroke remains rare in young adults, so there is no reason to panic. She said annual check-ups remain the best way to catch risk factors early.

Leppert said young women, who have strokes more often than young men, should watch their blood pressure during and after pregnancy. She said those on oestrogen-based birth control should tell their doctor about migraines with visual changes.

Know the Warning Signs

Doctors recommend the BE FAST checklist to spot a stroke: balance loss, vision changes, facial drooping, arm weakness and slurred speech. Anyone spotting these signs should call emergency services immediately, since treatment is highly time-sensitive.

Aaron Shoskes, a neurologist at University of Utah Health, said separate research points to the same traditional drivers, including cholesterol, obesity and smoking. He said certain cancers may also raise clot risk in younger patients.

Caffeine, vaping and stimulants may play a role for some people, Shoskes said, but should not overshadow traditional risk factors. He said quitting smoking and a heart-healthy diet remain the most effective steps.

The study found a modest decline in 30-day death rates among younger patients, suggesting treatment has improved. Researchers warned this could raise the long-term disability burden as more young people survive strokes.

Robinson said young adults often visit urgent care rather than a family doctor, making warning signs harder to catch. He said identifying high-risk patients in these settings is key to reversing the trend.

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