Stroke is more common in women compared to men, and this difference can be attributed to various risk factors that vary across different age groups.
Stroke deaths are rising at an alarming rate across the world, especially in the low and middle-income countries, where these fatalities are expected to surge from 6.6 million in 2020 to a staggering 9.7 million by 2050. In US, almost 8 lakh people suffer from stroke annually out of which women are more likely to die compared to men, as per a New York Times report. There are number of reasons why women are more at risk of strokes than their male counterparts, from longer life expectancy and risk of developing comorbid conditions to biological changes during menopause. Many women have an early menopause before they turn 40 compared to other women who undergo this crucial transition between the age of 50-51. This premature menopause can put them at a 98 per cent higher risk of stroke. Then there are other factors like using hormonal pills or risk factors during and immediately after pregnancy, added the NYT report. (Also read: Stroke could cause 10 million deaths by 2050; what causes stroke and lifestyle habits to reduce risk)
Strokes are a serious medical condition that can affect anyone, but studies have shown that women are more susceptible to strokes than men.
“Each year, over 6.6 million people globally succumb to strokes, and there’s a growing concern that the number of stroke incidents is on the rise, particularly among young and middle-aged individuals and in low-to middle-income countries. A recent report anticipates that by 2050, stroke-related deaths will surge by about 50%, amounting to 9.7 million deaths annually. Strokes occur when the brain’s supply of oxygen and nutrients is interrupted. This can be due to weakened blood vessels that rupture under pressure, resulting in a haemorrhagic stroke. More frequently, it’s caused by clots or plaque obstructing blood vessels leading to the brain, termed an ischaemic stroke. Both stroke types can inflict permanent harm or even death. Survivors of strokes often grapple with long-term disabilities, heightened depression risk, memory issues, and other complications,” says Dr Tushar Raut consultant, neurology at Kokilaben Dhirubhai Ambani Hospital, Mumbai.
“Stroke is more common in women compared to men, and this difference can be attributed to various risk factors that vary across different age groups. Younger women are at risk of stroke due to factors such as using oral contraceptives, during pregnancy, having preeclampsia, or gestational diabetes. On the other hand, older women are affected by changes in hormone levels and may also be influenced by using hormone therapy after menopause. The risk of stroke is higher during pregnancy and the postpartum period due to changes in blood clotting factors, which increases the risk of blood clots and stroke. According to a study, it was found that cardioembolism is a major cause of stroke in women, as compared to vascular atherosclerosis. One possible reason for this difference is the higher prevalence of valvular heart disease and nonvalvular atrial fibrillation in women. Additionally, the lower smoking rates among women make them less prone to atherothrombotic strokes. One important risk of increased risk is gender disparities exist in assigning risk categories and providing preventive treatment for women. It is also worth noting that women tend to experience more severe strokes. Women tend to experience more severe strokes than men. Also, female patients are at more risk of higher disability after stroke, and loss of independent function,” says Dr. (Col) Joy Dev Mukherji, Vice Chairman & Head- Neurology, Max Super Speciality Hospital, Saket.
Reasons why strokes are more common in women
Women are more susceptible to strokes compared to men due to various biological and lifestyle factors.
“Hormonal fluctuations associated with menstruation, pregnancy, and menopause play a significant role in increasing stroke risk in women. Risk during pregnancy increases due to the changes in blood pressure and stress on the heart. The use of birth control pills, especially among women who smoke or have high blood pressure, has been linked to a heightened risk of stroke. Post-menopause, the natural decline in oestrogen levels in women’s bodies also contributes to an increased stroke risk,” says Dr Raut.
Dr. Nitin Rai, Consultant – Neurology, Fortis Escorts, Okhla Road, New Delhi lists reasons why women are more susceptible to strokes.
Hormonal fluctuations: The hormonal changes that women experience throughout their lives, such as pregnancy, menopause, and the use of birth control pills, can affect their risk of stroke.
Longer life expectancy: Women tend to live longer than men, which means they have a longer lifespan during which stroke risk increases.
Higher prevalence of hypertension: High blood pressure is a significant risk factor for strokes, and it’s more prevalent in women, especially as they age.
Migraines and aura: Women who experience migraines with aura are at a higher risk of stroke. Understanding this connection is crucial for prevention.
Autoimmune diseases: Some autoimmune diseases, such as lupus and antiphospholipid syndrome, are more common in women and can increase the risk of strokes.
Socioeconomic factors: Social and economic factors may affect access to healthcare and lifestyle choices, which can influence stroke risk.
How women can avoid strokes; know preventive measures
To reduce the risk of stroke, women are advised to maintain a healthy lifestyle. This includes engaging in regular exercise, consuming a balanced diet rich in fruits and vegetables, and low in saturated fats.
“Managing blood pressure through regular monitoring and medication, avoiding smoking, limiting alcohol consumption, and managing diabetes effectively are also important as steps to reduce the risk of stroke. Regular health check-ups to monitor conditions like atrial fibrillation that might elevate stroke risk are essential. Women are also advised to exercise caution when considering hormone replacement therapy and oral contraceptives, particularly older women and those with additional risk factors. Consulting healthcare professionals for advice based on one’s individual health status is always recommended,” says Dr Raut.
“Women have traditionally been screened and treated for cardiovascular disease (CVD) less aggressively than men and hence proper screening leads to early detection of these risks. Women with a history of CVD and diabetes are less likely to meet target cholesterol levels. Adequate cholesterol lowering drugs and management of hypertension risk of stroke in women. Diabetes is a significant risk factor for stroke and heart disease in women, which need to be managed well as patients with these diseases have difficulty in reaching the blood pressure and cholesterol targets. Weight reduction and physical inactivity are the important interventions. The risk of falls should be balanced with the risk of stroke in older and frailer women. A healthy lifestyle is linked to a lower risk of stroke,” says Dr Mukherji.
Dr Rai shares the lifestyle measures that women must take to reduce risk of stroke and live a longer life
Control blood pressure: Regular monitoring and management of blood pressure are crucial. Women should work with their healthcare providers to maintain healthy blood pressure levels.
Healthy diet: A diet rich in fruits, vegetables, whole grains, lean proteins, and low in saturated and trans fats can help lower the risk of stroke.
Regular exercise: Engaging in physical activity helps maintain a healthy weight and reduces stroke risk. Aim for at least 150 minutes of moderate-intensity exercise per week.
Quit smoking: Smoking significantly increases the risk of stroke. Women who smoke should seek help to quit, and non-smokers should avoid exposure to secondhand smoke.
Limit alcohol: Excessive alcohol consumption can raise blood pressure and contribute to stroke risk. Women should follow guidelines for moderate alcohol intake.
Manage stress: Chronic stress can contribute to stroke risk. Relaxation techniques, mindfulness, and stress management strategies can help.
Hormone therapy: If considering hormone therapy for menopausal symptoms, consult with a healthcare provider to weigh the risks and benefits.
Regular check-ups: Women should schedule regular check-ups with their healthcare providers to monitor their overall health, discuss risk factors, and receive preventive care.
Know the signs: Recognizing the signs of stroke (FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 911) is crucial for prompt medical attention.
Education and advocacy: Women can educate themselves and their communities about stroke risk factors and prevention, advocating for better access to healthcare and resources.
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