Why women should know about stroke

Stroke is as much of a threat to women as it is to men. Protect yourself by learning about your risk factors and knowing the signs and symptoms.

It doesn’t get the attention that osteoporosis does.

And there are no pink ribbons or red dress campaigns to raise awareness like there are for breast cancer and heart disease.

Stroke, it might seem, isn’t on the country’s radar as a women’s health priority. But if you’re a woman, it should be on yours.

Each year, about 795,000 people have strokes in America, according to the American Heart Association. About 144,000 deaths are attributed to stroke each year.

Of those deaths, about 60 percent occur in women. For those who survive, stroke is a leading cause of long-term disability.

As a woman, you may have some unique risk factors for stroke. But you also have more power to prevent stroke than you might realize. By learning what puts you at risk and acting quickly if stroke occurs, you may be able to prevent a stroke or avoid its devastating consequences.

Recognize your risk

Strokes happen when blood is prevented from reaching the brain, usually by a blood clot or a broken blood vessel. Without adequate blood, brains cells die. That can cause trouble speaking, paralysis and other problems.

Depending on the severity of the stroke and how quickly it’s treated, brain damage can be permanent or even deadly.

Many risk factors for stroke apply to men and women, says Robert J. Adams, MD, spokesperson for the American Stroke Association. Among them:

• Increasing age.
• Family history.
• High blood pressure.
• Tobacco smoke.
• High cholesterol.
• Physical inactivity.
• Excess weight.
• Diabetes.
• Atrial fibrillation.

But some risk factors are unique to women.

Use of birth control pills. Birth control pills increase the likelihood of blood clots, says Dr. Adams. And that danger is compounded when you smoke.

“Certainly, you shouldn’t smoke to begin with,” he says, “But if you use birth control pills, you definitely shouldn’t smoke.”

Pregnancy. Although the risk is small, pregnancy increases a woman’s chance of stroke because, among other things, it raises blood pressure and puts stress on the heart.

Use of hormone therapy. A combined hormone therapy of progestin and estrogen, sometimes taken to lessen the physical effects of menopause, raises stroke risk, according to the National Stroke Association (NSA).

This doesn’t mean that all women should necessarily avoid hormone therapy, says Dr. Adams. But it does highlight the importance of weighing the potential advantages of hormone therapy against its known risks.

Having a thick waist and a high triglyceride level. Postmenopausal women with a waist size larger than 35.2 inches and a triglyceride level higher than 128 milligrams per deciliter may have a fivefold increased risk for stroke, reports the NSA.

The big picture

When deciding on a stroke-prevention strategy, it’s important to look at all of your risk factors together, according to Dr. Adams.

With your doctor’s help, you can identify specific steps you can take to bring your risk down. These steps might include:

• Managing high blood pressure, high cholesterol and health problems such as diabetes.
• Controlling your weight.
• Choosing a diet low in saturated fat and rich in fruits, vegetables and whole grains.
• Getting 30 minutes or more of exercise most days of the week.
• Quitting smoking.

For some women, additional steps, such as avoiding birth control pills or hormone therapy, or taking low-dose aspirin, might also be recommended. Your doctor can help you form the best prevention plan, based on your unique risk profile.

Speed matters

Should a stroke occur, act fast. Warning signs come on suddenly and may include:

• Numbness or weakness of the face, arm or leg, especially on one side.
• Confusion or trouble speaking or understanding.
• Trouble seeing in one or both eyes.
• Trouble walking, dizziness, loss of balance or loss of coordination.
• Severe headache with no known cause.

If you have any of these signs (even if they improve after a few minutes), call 911. Women may be reluctant to report their symptoms, says Dr. Adams. But delays in getting help can be costly.

Treatment with a drug called tissue plasminogen activator can dramatically lessen the effects of some strokes—but only if it’s given within three hours. This makes it important to note the time when symptoms begin.

“The clock starts when the symptoms start, not when you get to the emergency room,” says Dr. Adams. “One of the reasons we don’t use this important drug as much as we would like is because patients don’t get into the hospital soon enough.”

Remember, as a woman, you’re not immune to stroke. But you’re not powerless against it either. Educating yourself and taking the necessary steps to reduce your risk may help keep you healthy and independent.

reviewed 10/22/2009

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