Women and Stroke: Men are at a lower risk of developing cardiovascular disease than women before midlife, but as women go through menopause and hormone levels fluctuate, the incidence of heart disease begins to even out between the two genders. However, people still have the misconception that heart disease is a man’s illness, so much so that women are less likely to be diagnosed in a hasty manner when they have symptoms of a heart attack. As a result, they have a worse prognosis.
Cardiovascular disease and stroke are related to each other as each involves disease in blood vessels called arteries. When the inner arterial wall is damaged, plaque can accumulate within the walls of the arteries. If you’re unlucky, the plaque can rupture and a blood clot form, leading to a heart attack or stroke, depending on the blood vessels involved.
When it comes to stroke, women have greater odds of developing a stroke over a lifetime than does a man, and women are more likely to die of stroke relative to men. In fact, more than twice as many women die from a stroke as from breast cancer. So, women are at greater risk of stroke than men, but why?
What Causes Stroke?
The most common type of stroke is an ischemic stroke, an event where an oxygen-carrying blood vessel to the brain is blocked or reduced. The symptoms and the long-term impact of a stroke depend on which part of the brain sustains damage from the lack of blood flow. For example, if the reduced blood flow affects a portion of the brain involved in speech, the stroke sufferer may experience difficulty talking.
Other stroke signs and symptoms include weakness on one side of the body or in the face, visual problems, loss of coordination and balance, headache, or dizziness. The weakness, loss of coordination problems, and balance issues may improve over time with physical therapy, but some people experience long-term disabilities.
Stokes come in two main types. A stroke caused by a blocked blood vessel is referred to as an ischemic stroke. A less common type of stroke is a hemorrhagic stroke where a blood vessel ruptures, and blood enters brain tissue. Both forms of stroke require quick treatment to avoid permanent damage to the brain. Time is of the essence in preventing long-term deficits or death, as treatment is most effective when doctors administer it within 4 hours after the symptoms start.
A stroke sufferer can be left with long-term disabilities such as weakness or sensory loss on one side of the body, balance problems, or difficulty speaking. You can also die of a stroke, especially if you delay treatment.
Risk Factors for Women and Stroke and Why Women Are at Higher Risk
Risk factors for stroke include family history, high blood pressure, elevated cholesterol and triglycerides, diabetes, blood clotting disorders, obesity, excess use of alcohol, smoking, obesity, lack of physical activity, and having an irregular heart rhythm called atrial fibrillation. These risk factors are common in both men and women, so why do women develop more strokes?
One risk factor for stroke relevant women is using hormone replacement therapy and birth control pills. Studies show that hormone replacement therapy increases the risk of stroke by about a third. Some studies suggest that the type of hormone therapy boosts the odds of developing a stroke, whether hormone replacement therapy includes only estrogen or estrogen and progesterone, while others show all hormone replacement therapy carries a similar risk. Most of the increased risk is for ischemic stroke, not hemorrhagic.
This Heart Condition Raises the Risk
Another stroke risk factor is an irregular heart rhythm called atrial fibrillation, a common condition where the upper chamber of the heart beats in an unorganized, irregular manner. The risk of atrial fibrillation goes up with age, with the risk spiking in men after the age of 50 and in women after the age of 60. Having this condition boosts the risk of stroke in everyone but women are more likely to develop a stroke relative to men when they have atrial fibrillation.
On the plus side, there are treatments for atrial fibrillation that may lower the risk of developing a stroke, but women are less likely to receive treatment for atrial fibrillation relative to men. Obesity, and elevated cholesterol, high blood pressure, drinking alcohol, cardiovascular disease, and smoking are other factors that increase susceptibility to atrial fibrillation.
Another condition that’s more common in women than men that raises the risk of stroke is migraines with an aura. Migraine headaches can be painful and inconvenient but having migraines that include an aura have other downsides. People with a migraine that includes an aura experience visual effects like light flashes and patterns that appear during a headache. Studies show this sub-class of migraine headaches increases the odds of developing a stroke. In fact, research shows people who have migraines with aura are 2.4 times more likely to have a stroke relative to those without such headaches.
If you have migraines with aura, think of it as another risk factor for stroke and talk to your doctor. If that’s the case, it’s important to do what you can to treat other factors that predispose to stroke, including not smoking and avoiding overuse of alcohol. Also, control your blood pressure, blood sugar, and cholesterol.
The Bottom Line
Having a stroke is a frightening proposition, but there’s good news. A study published in the journal Circulation found that five lifestyle factors lower the risk of stroke. These lifestyle factors include not smoking, not overusing alcohol, eating a healthy diet, avoiding obesity, and staying physically active can prevent 80% of strokes. So, do what you can from a lifestyle standpoint to reduce your risk.
References:
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- 2008 Aug 26;118(9):947-54. doi: 10.1161/CIRCULATIONAHA.108.781062. Epub 2008 Aug 12.
- 2005;36(2):234. Epub 2004 Dec 23.
- American Heart Association. “How High Blood Pressure Can Lead to Stroke”
- Harvard Health. “Seven Things You Can Do to Prevent a Stroke”
- gov. “Strokes Signs and Symptoms”
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- Curr Vasc Pharmacol. 2008 Apr;6(2):112-23.
- Gend Med. 2009 Sep;6(3):419-32. doi: 10.1016/j.genm.2009.09.008.
- Medicina (Kaunas). 2019 Sep; 55(9): 602. Published online 2019 Sep 18. doi: 10.3390/medicina55090602.
- American College of Cardiology. “AFib Has Different Effects on Men and Women”
- American Stroke Association ” Women Have a Higher Risk of Stroke”
- American Heart Association. “Migraine with aura linked to clot-caused strokes”
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