3 ways women’s risk of stroke differs from men’s

Last February, the American Heart Association (AHA) and the American Stroke Association released newly recommended guidelines for the prevention of stroke in women of all ages. According to AHA experts, the majority of strokes in the U.S. strike women, with more than 60 percent of stroke-related deaths occurring in females. 

“Women share many of the same risk factors as men for stroke—high blood pressure, high cholesterol and diabetes—but there are risks specific to women’s physiology that elevate their risk even further,” says Dr. Raina Gupta, neurologist at Advocate Illinois Masonic Medical Center in Chicago. “Women’s hormones, reproductive health and pregnancy can all further contribute to the risk of stroke.” 

Additional stroke risk factors for women include migraine headaches with aura, atrial fibrillation and sleep abnormalities, Dr. Gupta says. In addition, blood pressure and diabetes have been found to be greater risk factors for women than men, she says. 

“Stroke is a very serious condition that can at any age, regardless of a woman’s overall health,” Dr. Gupta says. “These new guidelines are something every woman should keep in mind. It’s important that we increase stroke awareness among women.” 

Here are three ways she says women are more at risk for stroke than men: 

1. Basic biology
There are several aspects of a woman’s reproductive system that put them at greater risk, including birth control medications, postmenopausal hormones and health during pregnancy, Dr. Gupta says. 

“Oral contraceptives may increase your risk of stroke by increasing your blood pressure to unsafe levels,” she says. “This is particularly dangerous if you also smoke or have a prior history of thromboembolism (blood clots). Be sure to monitor your blood pressure when starting a new contraceptive.”

 Blood pressure also plays a part of stroke risk during pregnancy. Women with a history of moderate to severe high blood pressure before pregnancy should speak with their physicians to consider blood pressure medication, a low-dose aspirin regimen or calcium supplement therapy to lessen the risk of preeclampsia. 

“Women with preeclampsia have twice the risk of stroke, as well as a four-fold risk of high blood pressure later in life,” Dr. Gupta says. “So it should be recognized as a risk factor and discussed as early as possible.” 

In addition, postmenopausal women with a waist size larger than 35.2 inches and elevated triglycerides may have a risk of stroke that’s up to five times as high as women who don’t, she says. 

2. Splitting headache
“Women, especially those under age 55, who have migraine headaches and experience an aura are at a 2.5 times greater risk of stroke,” Dr Gupta says. “Women who are on birth control can be at an even greater risk.”

And it’s especially important women with migraines stop smoking, since that increases their risk even further, she says. 

3. Fluttering heart
Dr. Gupta says atrial fibrillation, a common type of fast, irregular heartbeat, is a stroke risk for women and men of any age. And the condition only increases with age. Dr. Gupta says women over the age of 75 should be screened for the condition to lessen their risk. 

“This is an especially important factor to pay attention to, as recent studies have shown that treatment of atrial fibrillation has not led to fewer related strokes,” she says. “So, early diagnosis and aggressive treatment are even more important.”