UKYSS is a large multicentre cohort highlighting the heterogeneous demographic characteristics, vascular risk factors and etiologies of young stroke in the UK.
The UKYSS cohort comprised 1765 first-ever strokes in young adults with a mean age of 41.6 years, of whom 61.7% were male and 82.4% were white.
Males had higher rates of hypertension, hyperlipidemia, and excess alcohol use, while females had higher rates of migraine and active malignancy.
Older young stroke patients (aged 45-49) had higher prevalence of traditional vascular risk factors compared to younger patients (aged 18-44).
White patients had higher rates of smoking, excess alcohol use, recreational drug use, and migraine, while non-white patients had higher rates of hypertension, diabetes, and hyperlipidemia.
Among ischemic strokes, 50.8% were cryptogenic and 38.1% were hypertensive, with 13.4% receiving intravenous thrombolysis and 5% receiving mechanical thrombectomy.
Among hemorrhagic strokes, hypertension was both the commonest risk factor (56.6%) and the commonest etiology (49.6%), and 15.3% of hemorrhagic stroke patients underwent neurosurgery.
This research presents baseline findings from the United Kingdom Young Stroke Study (UKYSS), one of the largest studies of stroke in young adults in the UK. The study followed 1,765 people aged 18-49 who suffered their first stroke across eight UK hospitals. The researchers found that stroke in young people is not a uniform condition — the risk factors and causes differ considerably depending on a person's sex, age group, and ethnicity. For example, younger adults (18-44) were more likely to have used recreational drugs or oral contraceptives as contributing factors, while older young adults (45-49) more closely resembled traditional stroke patients with high blood pressure, diabetes, and heart disease. Men were more likely to have cardiovascular risk factors like high blood pressure and high cholesterol, while women more often had migraine or active cancer. Ethnic differences were also notable, with non-white patients carrying higher burdens of metabolic conditions like hypertension and diabetes, and white patients showing more lifestyle-related risk factors. A striking finding was that over half of ischemic (clot-based) strokes in young people had no identified cause — classified as 'cryptogenic' — highlighting a major gap in understanding. High blood pressure dominated hemorrhagic (bleeding) stroke, being both the most common risk factor and the most common cause. Only a minority of patients received acute treatments such as clot-busting drugs (13.4%) or mechanical clot removal (5%), reflecting the challenges of treating stroke in younger populations who may present differently or be diagnosed later. This research suggests that stroke prevention and treatment strategies for young adults need to be tailored to account for these diverse demographic and risk factor profiles rather than applying a one-size-fits-all approach. The high proportion of unexplained strokes also points to a need for better diagnostic tools and investigation protocols for young stroke patients. Understanding these differences could help clinicians identify at-risk individuals earlier and guide more targeted prevention efforts across different population groups in the UK.
Ferdinand P, Maguire H, Bajpai R, Sokhal B, Ahmed S, Goraya J, et al.. (2026). Demographics, risk factor profiles and etiologies in young ischemic and hemorrhagic stroke - the United Kingdom Young Stroke Study (UKYSS).. Journal of neurology. https://doi.org/10.1007/s00415-026-14085-5