Women And Stroke

Stroke is the third leading cause of death in Canada and the tenth largest contributor to disability-adjusted life years (the number of years lost due to ill-health, disability or early death).

Stroke can happen to anyone, at any age. Yet stroke disproportionately affects women. Sadly, more women die of stroke than men, women have worse outcomes after stroke, more women are living with the effects of stroke and women face more challenges as they recover.

What is a stroke and what causes it?

A stroke is a sudden loss of brain function caused by a brain blood vessel blockage (ischemic stroke) or rupture (hemorrhagic stroke). In either case, parts of the brain become damaged or die. Symptoms of a stroke can include weakness or loss of sensation (often on one side of the body), confusion or difficulty speaking, vision difficulties, headache or loss of coordination and balance. The onset of these symptoms is typically sudden. The symptoms or subsequent complications of a stroke can persist and impact one’s quality of life.

What causes a stroke?

Ischemic strokes and hemorrhagic strokes can happen for many reasons. Ischemic strokes usually happen because of blood clots. These can happen for various reasons, such as:

  • Atherosclerosis (a narrowing of the arteries caused by a buildup of plaque)
  • Clotting disorders.
  • Atrial fibrillation (especially when it happens due to sleep apnea).
  • Heart defects (atrial septal defect or ventricular septal defect).
  • Microvascular ischemic disease (which can block smaller blood vessels in your brain).

Hemorrhagic strokes can happen for several reasons also, including:

  • High blood pressure, especially when you have it for a long time, when it’s very high, or both.
  • Brain aneurysms can sometimes lead to hemorrhagic strokes.
  • Brain tumors (including cancer).
  • Diseases that weaken or cause unusual changes in blood vessels in your brain, such as moyamoya disease.

How stroke affect women differently

Women and men share most of the same risk factors for stroke, such as health conditions like high blood pressure, high cholesterol, diabetes and atrial fibrillation (irregular heartbeat). Some lifestyle factors such as smoking and inactivity can also raise the risk of a stroke. However, there are other risk factors specific to women, such as:

Contraception (the pill)
Using the combined oral contraceptive pill (combi pill) is linked to a small increase in risk of stroke and blood clots for some people.

When you are being prescribed contraception, you should be checked for any risk factors like having a history of blood clots or stroke, having high blood pressure, being a smoker, or being very overweight. You should be given advice about your options and what is safe for you.

Pregnancy and stroke
Stroke is rare among pregnant women, but pregnancy and childbirth do increase your risk of a stroke. During pregnancy, regular blood pressure checks can spot the signs of preeclampsia, which is a condition that can increase the risk of a stroke.

Migraine
Migraine affects more women than men, and although it is not a direct cause of stroke, it’s linked with an increased risk if you have migraine with aura. Although the added risk is small, it means you might not be able to use the pill or some types of HRT.

Lupus and SLE
Lupus is an autoimmune condition affecting the skin and joints, causing pain, fatigue and sometimes kidney damage. The severe form is called systemic lupus erythematosus (SLE).

Several studies also suggest that women may be treated less aggressively for primary and secondary stroke prevention and acute stroke compared with men. In general, women also have higher rates of depression and lower quality of life than men and are more likely to require assistance after a stroke, even when controlling for factors such as age and premorbid function.

How women can prevent a stroke

It’s not possible to completely prevent strokes because some things that increase your risk of the condition cannot be changed.

These include:

  • age – you’re more likely to have a stroke if you’re over 55, although about 1 in 4 strokes happen to younger people
  • family history – if a close relative (parent, grandparent, brother or sister) has had a stroke, your risk is likely to be higher
  • ethnicity – if you’re of south Asian or African descent, your risk of stroke is higher, partly because rates of diabetes and high blood pressure are higher in these groups
  • your medical history – if you have previously had a stroke, transient ischaemic attack (TIA) or heart attack, your risk of stroke is higher

It’s possible to significantly reduce your risk of having a stroke by making lifestyle changes to avoid problems such as atherosclerosis and high blood pressure. Additionally, getting a stroke risk screening is a great way to proactively measure your probability of getting a stroke in the future.

InvestMed allows you to choose between a risk specific stroke screening package or a comprehensive screening package designed to meet the individual needs of all our patients in BC and Calgary. Each package includes a comprehensive 1 hour physical exam and 1 hour review of results with recommendations to achieve optimal health. Call us at 236.766.0997 or online now to learn more.

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