Someone in the US has a stroke every 40 seconds. Stroke is the third leading cause of death among women. In fact, midlife women face a higher risk of stroke than midlife men do. In case you thought you didn’t need to worry about stroke, you’re wrong. Here’s what you should know about stroke and women in particular.
Kinds of Strokes
There are three main types of strokes.
Hemorrhagic stroke results from rupture of a blood vessel that leads to bleeding in the brain. This type accounts for about 13% of all strokes but it is more likely to lead to death. Fatality rate may be as much as 50% higher than for ischemic stroke.
Ischemic stroke results when blood supply to part of the brain is diminished or blocked. This results from an obstruction that could be caused by a clot, embolism in another part of the body or reduced blood flow for some other reason.
Transient Ischemic Attack (TIA)
TIAs are often called “mini-strokes.” They are brief interruptions of blood flow to the brain that result in symptoms which usually resolve completely within 24 hours.
But TIAs are warnings you shouldn’t ignore. Eleven percent (11%) of people who experience TIA symptoms have another stroke within the next 7 days. And 24-29% have another stroke during the next 5 years. Thus as many as 40% of people who have a TIA end up having another stroke within the 5-year period afterward.
Stroke consequences are serious
About 1 in 6 strokes are fatal. Even if a stroke doesn’t kill you, it can leave you with significant disability. In fact, stroke is a leading cause of long-term disability.
Half of stroke survivors age 65 and older experience reduced mobility as a result of the stroke. Other stroke disabilities include partial paralysis, speech or vision problems, memory loss, as well as behavioral and emotional changes.
Stroke costs are enormous, both to individuals and society. In the US alone, the cost of stroke care exceeds $34 billion per year. This includes health care services, medications and missed days of work.
Stroke and women
Stroke ties for the third leading cause of death for all women at 6%. It falls after heart disease (22%) and cancer (21%) and is roughly equal to chronic lower respiratory disease (6%).
Women face higher stroke risk than men in midlife
Analysis of data from the National Health and Nutrition Examination Survey found that among women aged 45-54, stroke risk was significantly greater than it was for men of the same age.
And because the average woman lives longer than the average man, a stroke will have a more negative impact on her life.
Consequences of stroke for women
Partly because women outlive men, they are more likely to live alone when they have a stroke.
And stroke makes it harder for them to live independently afterward. Thus more women move into long term health care facilities after having a stroke.
Finally, research shows that women’s recoveries from stroke are worse than men’s. In one example, women had lower functional recovery and poorer quality of life three months after discharge than did their male counterparts.
Risk factors for stroke
According to the American Heart Association, there are three types of risk factors for stroke.
Factors you can control and/or treat
- High blood pressure
- Physical inactivity
- High cholesterol
- Carotid artery disease – fatty deposits in the arteries carrying blood to your brain
- Peripheral artery disease – fatty deposits in arteries of legs or arms
- Atrial fibrillation – heart rhythm disorder that makes you 5 times more likely to have a stroke
- Other heart diseases
- Sickle cell anemia
Factors not within your control
- Family history
- Race – blacks have nearly double the risk of death from stroke as whites
- Gender – women have more strokes than men and die from stroke more often than men
- Prior stroke, TIA or heart attack
Additional factors that may link to stroke risk
- Geographic location – US strokes are more common in Southeastern states
- Socioeconomic factors
- Alcohol and drug abuse
- Sleep habits/sleep apnea
Specific risks for stroke and women
Some additional factors for stroke apply to women. According to the National Stroke Association, they include:
- Taking birth control pills – of highest concern if you have other risk factors like age, smoking, diabetes or high blood pressure
- Being pregnant – normal pregnancy increases blood pressure and stress on the heart
- Using Hormone Replacement Therapy (HRT) – one of the reasons HRT for menopausal women is controversial
- Suffering from migraine headaches with aura – most migraine sufferers are women, and migraines can increase women’s risk of stroke by 2.5 times
General symptoms of stroke
Harvard Health Publishing lists the following symptoms of stroke:
- weakness in an arm, hand, or leg
- numbness on one side of the body
- sudden dimness or loss of vision, particularly in one eye
- sudden difficulty speaking
- inability to understand what someone is saying
- dizziness or loss of balance
- sudden, lasting, excruciating headache
The National Stroke Association lists more symptoms that may indicate a woman is having a stroke beyond the general indicators:
- Loss of consciousness or fainting
- General weakness
- Difficulty or shortness of breath
- Confusion, unresponsiveness or disorientation
- Sudden behavioral change
- Nausea or vomiting
The biggest problem with unique symptoms like these is that they often aren’t recognized as symptoms of a stroke. Thus treatment can be delayed, resulting in worse outcomes for women.
F.A.S.T. – Recognize and treat stroke
The American Heart Association promotes the acronym FAST to help people recognize and get immediate medical attention for a stroke. Their graphic, available in different forms, summarizes FAST stroke symptoms and response.
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 9-1-1
3-hour magic window
It’s critical to treat a stroke as quickly as possible. The goal of treatment generally is to restore blood flow before brain cells die. Doctors have the best chance of preventing brain tissue death (and thus stroke disability) if they can start treatment within 60 minutes.
One of the principal drugs used to dissolve clots caused by stroke is recombinant tissue-plasminogen activator (tPA). To be effective, tPA must be given within 3 hours of the start of stroke symptoms. Earlier is better.
A big issue: being able to treat a stroke early means you have to recognize it’s happening. Yet a Gallup survey found that 97% of of adults age 50 and over didn’t know the warning signs for stroke.
Don’t be one of the 97%. The life you save may be your own.
My Stroke of Insight
Brain scientist Jill Bolte Taylor gave a TED talk in 2008 that’s been viewed over 23 million times. In it, she describes her personal experience of having a stroke and observing as her brain functions shut down.
It’s a fascinating talk that’s entertaining, frightening and encouraging, all at the same time.
Taylor also describes this experience in her book, My Stroke of Insight: A Brain Scientist’s Personal Journey*.
She talks not only about how she felt during her stroke, but how it gave her an appreciation for her “two cognitive minds.” As a scientist, she had always tapped into her left brain hemisphere. But she conveys her insight about the importance of choosing to access the right brain hemisphere also.
She also appears to have recovered fully from her stroke – another encouraging aspect of the talk.
Preventing stroke goes back to the risk factors you can control or treat, like high blood pressure, cholesterol, diabetes and obesity.
Also be on the lookout for aFib (atrial fibrillation). This condition can cause blood to pool in the heart’s upper chambers. A blood clot can form, dislodge and travel to your brain.
Your doctor may prescribe blood thinners or other interventions to prevent clots and stroke if you have aFib. Awareness of your condition can also motivate you to make healthy lifestyle choices for diet, exercise and so on.
The bottom line on stroke and women
Stroke kills twice as many women as breast cancer every single year. Most people don’t know this.
Women tend to be less knowledgeable about stroke risk factors generally. Indeed, we don’t consider ourselves to be at risk for strokes. But we are.
By learning to recognize a possible stroke and obtain quick medical help, you can prevent long term disability and even death. Take time right now to educate yourself and commit the FAST acronym to memory.
You’ll be glad you did.