Ohio leads country in percentage increase of strokes: What’s causing it

Ohio stroke prevalence increased by 20.9% compared to national average of 7.8%.

Mickey Stewart had a stroke in November that changed his life immediately.

“I couldn’t walk. I couldn’t speak. I couldn’t use my arm. I couldn’t do math. I couldn’t do anything,” the 30-year-old Dayton resident said.

After seeing a few years of declining strokes, the U.S. has reversed course, seeing increases in the prevalence of strokes over the last decade, with Ohio leading the nation, according to the Centers for Disease Control.

Ohio saw the largest percentage increase in the prevalence of strokes, increasing by 20.9% when comparing to 2020–2021 to 2011–2013, the CDC says in a recent morbidity and mortality report.

Ohio saw the largest percentage increase in people who have had a prevalence of a stroke in the past decade compared to the previous decade, according to the CDC.

In the U.S., the percentage of people increased by 7.8% comparing the same time frame. These increases contrast with the decrease of 3.7% reported during 2006–2010, according to the CDC.

Stroke is the fifth leading cause of death in the United States and a leading cause of long-term disability.

“It is the number one cause of disability, so when it affects a person, it affects the whole family,” said Dr. Esteban Cheng-Ching, a stroke neurologist at the Clinical Neuroscience Institute with Premier Health.

“Suddenly, the person is not able to function as before,” he said.

Recovery from stroke

Stewart was hospitalized for a couple of weeks at Kettering Health Main Campus, trying to learn how to walk and talk again, before being discharged and spending time at the Kettering Health NeuroRehab and Balance Center.

“I had three different therapists working on different parts of me. They were absolutely wonderful,” Stewart said.



It was something that he never expected to go through.

“For me, my whole life, I knew how to read,” Stewart said. “I knew how to walk. I knew how to use my arm. I knew how to speak. That was nothing new.”

Then, the experience of losing those motor skills and having to retrain his mind and body was surreal for Stewart.

“(It was) very strange that I couldn’t open up a chapter book up and read it,” Stewart said.

Health issues putting people at risk

Risk factors for strokes include family history, high cholesterol, high blood pressure, heart disease, smoking, diabetes, obesity, the CDC says. Risk factors can be genetic and out of a person’s control.

Those health issues are experienced by many Ohioans. Heart disease is the leading cause of death in Ohio, according to the Ohio Department of Health. More than one third of adults, or 34.5% of adults, in Ohio have been diagnosed with hypertension, but ODH says true prevalence of hypertension is likely closer to 50% of Ohio adults.

High blood pressure can injure the blood vessels, causing the vessels to narrow, or harden the blood vessels and make them more prone to narrowing and forming clots, Cheng-Ching said.

High cholesterol promotes the formation of plaques in the blood vessels, which can narrow the vessels and form clots, and diabetes can injure blood vessels, which can lead to blockages in blood formation, he said.

Certain social groups were associated with higher prevalence of strokes, the CDC’s recent report says. Significant increases in stroke prevalence were observed among adults aged 18–44 and 45–64 years; females and males; Black, white and Hispanic adults; and adults with less than a college degree.

Credit: Jim Noelker

Credit: Jim Noelker

Many of health issues―high blood, high cholesterol, and diabetes―are creeping into younger populations, said Kettering Health neurosurgeon Dr. Akil Patel.

“What’s happening is even though we’re trying to be healthier with our elderly, we might be missing the boat necessarily when it comes to those younger patients,” Patel said.

Why Ohio?

Many Ohioans experience those health issues putting people at risk. Nearly 37% of Ohio adults have high cholesterol and 12.4% of Ohio adults were diagnosed with diabetes, ODH says.

Multiple rankings also have Ohio in the top 10 states for obesity, with U.S. News and World Report ranking Ohio sixth in the nation with a rate of 38% of obesity.

“What’s scary about Ohio is we are right above what we call the Stroke Belt,” Patel said.

The Stroke Belt is a region of higher stroke mortality in southeastern states, which has persisted since at least 1940, the American Heart Association says.

Top 10 states that saw the largest increases in the prevalence of stoke, 2011-2022, according to the CDC
North Dakota18.5%

“I’m afraid if we don’t really work on trying to change some of these things, sooner or later, we’re going to be in that Stroke Belt,” Patel said.

The cost burden of strokes for U.S. residents was approximately $56.2 billion during 2019–2020, according to the CDC.

“It’s a huge, huge direct and indirect cost to our community as a whole,” Patel said.

What can people do?

Prioritizing regular health screenings and blood tests are key in order to catch certain health risks.

High blood pressure and high cholesterol, both referred to as “silent killers,” often don’t present any noticeable symptoms, so people should maintain regular health visits with their primary care doctors, Patel said.

Doctors also recommend exercise, such as at least 30 minutes of activity a day, as well as decreasing fried foods, decreasing your desserts, have it in moderation, and focus more on white meats, vegetables and fruit rather than fast food and high cholesterol foods.

Credit: Jim Noelker

Credit: Jim Noelker

Learning the signs and symptoms of a stroke can help people catch a stroke early while it’s happening in order to prevent as much damage as possible. There are also procedures that can be done to remove clots in order to try to prevent certain strokes.

Signs of a stroke include the following:

  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking, or difficulty understanding speech.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
  • Sudden severe headache with no known cause.

Recovering from a stroke can be difficult, but Stewart has maintained a positive attitude even while he has had to start from scratch.

“It’s been a process, but in a weird way, it’s also been a fun process, which sounds really strange, but I can’t take it back, right? I didn’t choose to have the stroke. It happened to me,” Stewart said.

He has made relearning how to read fun, reading certain books he doesn’t remember reading or didn’t read earlier in life as he works his way back up through different reading levels.

“I’m trying to relearn some instruments and relearn the artwork that I used to do,” Stewart said. “It sucks. It’s not great, it’s unfortunate, but if it’s going to happen to you, if there’s nothing you can do to stop it, might as well have some fun with it, right?”

Act F.A.S.T.

The stroke treatments that work best are available only if the stroke is recognized and diagnosed within three hours of the first symptoms, according to the Centers for Disease Control.

Stroke patients may not be eligible for these treatments if they don’t arrive at the hospital in time.

If you think someone may be having a stroke, act F.A.S.T. and do the following test:

  • F—Face: Ask the person to smile. Does one side of the face droop?
  • A—Arms: Ask the person to raise both arms. Does one arm drift downward?
  • S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
  • T—Time: If you see any of these signs, call 9-1-1 right away.

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