Women face special dangers of stroke
Young female nurse assisting female patient on crutches in hospital
Senior woman having ambulatory therapy
Senior woman having ambulatory therapy
Each year, around 55,000 more women than men will have a stroke.
Longer lifespans, pregnancies and hormones all contribute, as do illnesses that tend to strike women more frequently.
Dr. Eli Feen, an associate professor of neurology at Saint Louis University, said in a press release that one reason stroke affects more women is simply because they live longer than men and the longer a person lives, the more risk they have of suffering a stroke.
Kristy Chambers, stroke coordinator at Ogden Regional Medical Center, said stroke is the fifth leading cause of death for men, but the third leading cause of death for women.
“By 2030, there will be an estimated 72 million people over 65 years old, and women will increasingly outnumber men. Some of the impact is explained by the fact that women live longer, and thus the lifetime risk of stroke in those aged 55 to 75 years is higher in women than men,” Chambers said. “Women are more likely to be living alone and widowed before stroke, are more often institutionalized after stroke, and have poorer recovery from stroke than men.”
Other risk factors for stroke among women include pregnancy and hormones. Birth control pills and hormone replacement therapy also raise the risk of stroke.
Chrisi Thompson, stroke program coordinator at McKay-Dee Hospital, said due to the physiological changes that occur during pregnancy and the post-partum phase, the risk for stroke is about three in 10,000 in pregnant women compared to women who are not pregnant, or two out of 10,000. Pregnancy-related hypertension, or pre-eclampsia and eclampsia, is the leading cause of stroke in pregnant and post-partum women. Additionally, women with a history of hypertension during pregnancy have an increased risk of hypertension later in life.
“Pregnant women should be screened for high blood pressure and treated with medications that are safe for pregnancy,” Thompson said. “Additionally, women who have high blood pressure, or previous pregnancy-related hypertension, should also be screened and treated appropriately.”
Thompson also said women who take even a low-estrogen birth control pill may be twice as likely to have a stroke than those who don’t. The risk of stroke may increase if other risk factors are present such as being over age 35, smoking, and high blood pressure. Women who take birth control pills should not smoke, and should also be screened and treated for high blood pressure.
Chambers said hormone replacement therapy can also increase the risk of blood clots forming, which can result in deep vein thrombosis, heart attack and stroke.
In addition, Chambers said, women are more often diagnosed with certain health conditions that are associated with stroke, such as migraines and atrial fibrillation. Migraines, which women suffer from more frequently than men, can increase your risk of having a stroke, especially if they include visual auras and other changes in vision.
Women are also more likely to suffer from certain types of inflammatory and auto-immune diseases, like lupus, that create an increased risk of blood clots, which, in turn, increases the risk of stroke.
Thompson said atrial fibrillation is more common in women over the age of 75; therefore, it’s recommended that all women should be screened. If you have atrial fibrillation, it’s important to talk to your doctor about the right treatment option for you and maintain compliance in the management of atrial fibrillation.
Thompson and Chambers said the symptoms of a stroke include sudden numbness or weakness of face, arm or leg, especially on one side of the body, sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination and sudden severe headache with no known cause.
“Never wait to see if stroke symptoms will get better or go away before seeking medical attention,” Thompson said. “If you experience even one stroke symptom, call 911 immediately. Note what time the stroke symptoms started or what time you were last seen in your normal state of health. This time is important for the medical personnel at the hospital to make the best possible treatment decision for you.”
Every minute that treatment for stroke is delayed, 32,000 brain cells die, Thompson said. The only FDA-approved treatment for stroke is an intravenous clot-busting medication called tPA (tissue plasminogen activator). Strict criteria must be met to receive the medication, including giving it within three hours of the time the person was last seen normal. There are also other medical devices available, extending beyond the three-hour window, in which the clot can be retrieved.
“The number one reason why tPA is not given more often is because people do not seek medical attention soon enough. One of the best things a person can do to increase survival rates and outcomes is to recognize stroke symptoms quickly and call 911 immediately,” Thompson said. “Fast recognition of stroke symptoms can increase your chance of getting to the appropriate hospital and receiving the appropriate treatment, in the appropriate amount of time.”
In the meantime, Thompson and Chambers said it’s vital to know your risks and modify your lifestyle:
— Know your blood pressure, if high, work with your doctor to lower it.
— Find out from your doctor if you have atrial fibrillation.
— If you smoke, stop.
— If you drink alcohol, do so in moderation. Only one drink per day for women.
— Find out if you have high cholesterol. Work with your doctor to lower it.
— If you are diabetic, follow your doctor’s recommendations carefully to control your diabetes.
— Include exercise in the activities you enjoy in your daily routine.
— Follow a lower sodium, lower fat diet.
— If you are overweight, work toward a healthier weight.