Strokes may be seen as an affliction that only affects older people, but according to a far-reaching study, strokes rates are soaring among young and middle-aged people around the world.
Experts have said it's a 'stark warning'. In 20 years, the number of strokes afflicting people aged 20 to 64 rose by a quarter, researchers found.
Strokes suffered by this age group now make up 31% of the global total, compared with 25% prior to 1990.
For the first time, researchers also studied stroke rates among children and young people aged 20 and under.
They found that each year more than 83,000 people in this age group were affected by stroke, 0.5% of the total number of cases.
If the current trend continues, the amount of disability, illness and premature death caused by strokes is expected to double worldwide by 2030.
Stroke Association chief executive Jon Barrick described the research as a "wake-up call to governments across the globe".
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The findings, from a major analysis of stroke burden around the world, are published in the latest issue of The Lancet medical journal.
The research forms part of the Global Burden of Disease Study 2010, a systematic analysis of data on major diseases and causes of ill health in 50 countries.
The results reveal stark differences between rich and poor.
Between 1990 and 2010, strokes were associated with 46% more disability and illness and 42% more deaths in poorer than in richer countries.
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In high income countries, stroke rates fell by 12% over the two decades.
Lifestyle risk factors such as smoking, high blood pressure, and unhealthy diet were thought to play a role in increasing stroke burden in low-to-middle income countries.
Lead scientist Professor Valery Feigin, director of the National Institute for Stroke and Applied Neurosciences at AUT University in New Zealand, said: "The worldwide stroke burden is growing very fast and there is now an urgent need for culturally acceptable and affordable stroke prevention, management and rehabilitation strategies to be developed and implemented worldwide."
Each year, around 152,000 occur in the UK, costing the NHS an estimated £3.7 billion.
Mr Barrick said at least half could be prevented by simple lifestyle changes, such as taking more exercise.
While the study showed a reduction in first-time stroke and stroke death rates in the UK, a British person was still more likely to die from stroke than someone living in France, Germany and the US.
"The report reveals a shocking disparity between rich and poor, where death rates from stroke are up to 10 times higher in lower income countries," Mr Barrick said.
"Closer to home, within the UK, the number of people dying from stroke is around three times higher in the most economically deprived areas, compared to the least deprived.
"To help close this health inequality gap, we need more investment in stroke prevention and research."
He added: "Rising obesity and diabetes rates, coupled with sedentary and unhealthy lifestyles, could wipe out the improvements we've seen in reducing stroke mortality in the UK, putting even more pressure on our limited NHS resources.
"We urgently need to address this global stroke crisis by prioritising stroke prevention and investment into stroke research."
A second study published in The Lancet Global Health showed that in 2010, three-fifths of the global disability and more than half of deaths due to stroke were the result of bleeding in the brain.
This type of stroke, known as a haemorrhagic stroke, is deadlier than more common ischaemic strokes that cut blood supply to the brain.
It is also more associated with high blood pressure and unhealthy lifestyle.
Most of those affected by haemorrhagic stroke are people younger than 75 and those living in low-to-middle income countries.