News

Younger adults facing stroke risk, doctors warn

Published on 29 October 2025

Unhealthy lifestyles and stress are putting more people at risk of stroke — a wake-up call for healthier living.

At a glance

Over 9,600 stroke events recorded in 2021
Sharp rise among those aged 40–49 — over 30 per cent increase in a decade
Stress, poor diet and smoking among key risk factors
Six in ten young stroke patients had clogged or damaged arteries or risk factors that lead to it

More Singaporeans in their 30s and 40s are suffering strokes — a condition once associated with the elderly — as national data show a sharp increase in cases among younger adults.

Rates have risen sharply in the past decade, with the number of stroke events climbing from over 6,100 in 2011 to more than 9,600 in 2021, according to the Singapore Stroke Registry Annual Report 2021.

While most patients were aged 60 and above, the surge among younger adults was striking. From 2011-2021, the incidence among those aged 40 to 49 rose by about 33 per cent, and among those aged 50 to 59, by around 13 per cent.

“It’s a growing concern that affects people in their prime working and family years,” said Dr Benjamin Tan, Consultant at the Division of Neurology, Department of Medicine, National University Hospital (NUH).

Rising risks behind the trend

Part of the increase reflected better recognition and faster diagnosis, Dr Tan explained. However, much of it, he cautioned, stemmed from real increases in vascular risk factors among younger adults.

A local study led by NUH including 276 young adults aged 18 to 50 with ischaemic stroke found that nearly six in ten had either atherosclerosis, the hardening of arteries, or the risk factors that cause it.

“Put simply, the same wear and tear on blood vessels that we expect to see in older adults is now showing up in people of younger ages with stroke,” said Dr Tan.

Common culprits included high blood pressure, high cholesterol, diabetes and smoking. Other causes of young-onset stroke include heart abnormalities such as patent foramen ovale (a small channel between heart chambers), blood-clotting or autoimmune disorders, and arterial dissections, which are small tears in blood vessel walls.

Each young stroke case, he stressed, needs a thorough, individualised evaluation to identify the cause and guide treatment.

Different strokes, same danger

Strokes fall into two main types: ischaemic, which occurs when a blood vessel is blocked, and haemorrhagic, caused by bleeding in the brain.

About 80 per cent of strokes are ischaemic, and while this remained the most common type across all ages, haemorrhagic strokes were relatively more frequent among younger adults, often linked to hypertension, aneurysms or vascular malformations.

Both types of stroke can result in permanent disability, cognitive decline, and a dramatically altered quality of life.

The danger of delay

Stroke symptoms are the same regardless of age: sudden weakness or numbness, slurred speech, blurred vision, loss of balance, or a severe headache in some cases.

“The difference lies not in symptoms but in interpretation,” said Dr Tan.

He stressed the importance of recognising the FAST warning signs:

Face drooping
Arm weakness
Speech difficulty
Time to call 995

“Even mild or fleeting symptoms can signal a serious stroke,” he warned. “Every minute counts.”

Genes and generation risk

While lifestyle and metabolic factors dominated, genetics also played a role in young-onset stroke.

One example was familial hyperlipidaemia, an inherited condition that causes very high cholesterol even in those who eat well and exercise. Another was CADASIL, a rare single-gene disorder that directly causes stroke and can lead to early dementia.

“These rare genetic causes account for about three to five per cent of strokes in young adults,” said Dr Tan. “Identifying them is important not just for treatment but also for family screening in some cases.”

Still, he added, “Genes are not destiny. Even with a strong family history, lifestyle choices and early treatment can dramatically reduce risk.”

Prevention starts early

For Dr Tan, the key message was clear: do not wait until you are older to think about stroke prevention.

“Many young people assume they’re too healthy to worry about blood pressure or cholesterol, but evidence shows otherwise,” he said.

He advised regular health screening, quitting smoking, staying active and eating a balanced diet low in salt, sugar and unhealthy fats.

“Singapore’s food culture is wonderful, but we must be mindful that many of our favourite dishes can be deceptively high in sodium and calories,” he added.

He also recommends at least 150 minutes of moderate exercise a week, along with stress management and adequate sleep to improve brain health.

A call for awareness

As Singapore’s population ages, the burden of stroke will continue to grow, but the trend among younger adults poses a new and urgent challenge.

“Stroke can strike anyone, even those who consider themselves fit and healthy,” said Dr Tan.

“Recognising symptoms early and seeking treatment immediately can make the difference between recovery and lifelong disability.”

His message was simple: think stroke, act fast, and start prevention early.

In consultation with Dr Benjamin Tan, Consultant, Division of Neurology, Department of Medicine, NUH.