A Stroke Prevention Guide for Women

By Deborah Pike Olsen

When you’re living a heart-healthier lifestyle, you’re not only working to protect your ticker, but you’re also helping your brain ward off stroke. There are two types of these “brain attacks”: The most common is ischemic, in which a blood vessel in the brain becomes blocked; the second type is hemorrhagic, in which a blood vessel ruptures and bleeds into the brain. Stroke is the third leading cause of death in the U.S. (behind heart disease and cancer), and women are more likely to die from it than men. In fact, this year, more than 100,000 women under 65 will suffer one, according to the American Stroke Association. Serious side effects can result, including vision problems, paralysis, memory loss, and speech and language problems, and sometimes even death.


While many of the risk factors for stroke and heart disease are similar (high-blood pressure, smoking, diabetes, lack of exercise and a diet high in fat and salt), some are unique—especially for women. Here’s the lowdown:


• Migraines Women who suffer from migraines with aura (visual disturbances like flashing lights) are more likely to have an ischemic stroke compared to those who don’t, according to two recent studies. Researchers found that the risk increases even more if a migraine sufferer smokes, uses birth control pills and is under age 45, according to a study published last year in British Medical Journal. If you experience migraines with aura, experts advise quitting smoking and avoiding birth control pills. And, of course, speak with your doctor first.


• Birth-control pills Taking a low-dose birth control pill on its own—without any other risk factors—may significantly up your risk of suffering a stroke, according to new and emerging research published last year in MedLink Neurology. The Pill may increase your chance of developing blood clots and high-blood pressure, both of which can contribute to a stroke.


• Hormone replacement therapy (HRT) In a review of 28 studies published in the British Medical Journal, women who took HRT had a significantly greater chance of suffering an ischemic stroke than those who did not—and their recovery tended to be worse. Researchers aren’t sure why HRT increases the risk of stroke, but the hormone estrogen may play a role.


• Autoimmune diseases Women are three times more likely than men to suffer from one of these illnesses, which cause the body’s immune system to attack various organs and systems. Several autoimmune diseases raise your risk of stroke. Women with antiphospholipid syndrome, a disorder in which immune cells attack the lining of blood vessels, are prone to developing blood clots, making them more susceptible to stroke. Taking low-dose aspirin or other medications, such as warfarin, help thin the blood, reducing the risk. Another common autoimmune disease that can lead to stroke is lupus. It can cause blood clots and create inflammation inside blood vessels, blocking blood flow. Treatment includes steroid medications to reduce inflammation and aspirin.


• www.bmj.com/cgi/content/full/339/oct27_1/b3914


• www.bmj.com/cgi/content/full/339/oct27_1/b4380


• www.loyolamedicine.org/News/News_Releases/news_release_detail.cfm?var_news_release_id=973441061


• www.bmj.com/cgi/content/full/330/7487/342


• www.thelancet.com/journals/laneur/article/PIIS1474-4422(09)70239-X/fulltext


• www.ninds.nih.gov/disorders/antiphosphlipid/antiphospholipid.htm


• stroke.about.com/od/causesofstroke/a/lupus_stroke.htm


• www.aarda.org/women_and_autoimmunity.php

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