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About Strokes and Women

Although many women believe that breast cancer is the disease to fear as they grow older, strokes kill more than twice as many women as breast cancer each year, according to the National Stroke Association (NSA).

Women have just over 40 percent of the strokes each year in this country, but those strokes more often end in death for women than for men, the NSA says.

What can women do about these grim statistics? Experts recommend taking steps to prevent strokes from occurring by making lifestyle changes and learning the symptoms of stroke so that if one occurs, a woman seeks prompt medical attention. About one-third of women cannot recognize the symptoms of a stroke -- or that those symptoms require immediate medical care.

What is a stroke?

A stroke occurs when the blood supply to the brain is suddenly interrupted by a blood clot or when a blood vessel in the brain bursts. A stroke caused by an interrupted blood supply is called an ischemic stroke. A stroke caused by a burst blood vessel, which spills blood into the surrounding brain tissue, is called a hemorrhagic stroke.

The clots that cause an ischemic stroke can be formed in the arteries of the brain. They can also travel from another blood vessel and become lodged in the small arteries of the brain, blocking the flow of blood. The clots that form in the arteries of the brain are formed from fatty deposits in the arteries in a process called atherosclerosis. Clots that travel to the brain are often caused by a condition called atrial fibrillation. This is a condition in which two small chambers of the heart, the atria, beat inefficiently and cause a rapid heart rate.

A stroke that occurs from a ruptured or leaking blood vessel in the brain can be cause by uncontrolled hypertension (high blood pressure), a head injury, or an aneurysm. An aneurysm is a weakness in the wall of a blood vessel.

According to the National Institute for Neurological Diseases and Stroke (NINDS), the symptoms of a stroke include:

• Sudden numbness, weakness or paralysis, especially on one side of the body
• Sudden confusion, trouble speaking, or trouble understanding another's speech
• Sudden vision problems (such as blurred, double or decreased vision) in one or both eyes
• Sudden, severe headache (usually described as the worst headache in your life)
• Sudden difficulty walking
• Dizziness, or loss of balance or coordination

For most people, a stroke gives no warning. But one possible sign of an impending stroke is a transient ischemic attack (TIA). A TIA is a temporary interruption of blood flow to a part of your brain. The symptoms of TIA are the same as for a stroke, but they appear for a shorter period -- usually less than five minutes -- and then disappear, without leaving apparent permanent effects. You may have more than one TIA, and the recurrent symptoms may be similar or different. A TIA indicates a serious underlying risk that a full-blown stroke may follow. More than a third of people who have had a TIA go on to have a stroke.

When a stroke occurs, and the brain cells cannot get the oxygen and nutrients they need, the brain cells die. This damage can result in permanent disabilities -- loss of movement and speech. But with immediate medical treatment, the brain cells often can be saved.

Who is at risk?

According to the American Stroke Association (ASA), risk factors for stroke in women include:

• Age. Although a stroke can occur at any age, the risk for stroke increases after a woman goes through menopause. The chance of having a stroke about doubles for each decade of life after age 55.
• Family background. If a close relative has a stroke, a woman is at higher risk for having a stroke herself. African American women are more likely to have a stroke than Caucasian women.
• Previous stroke, TIA, or heart attack. If a woman has had a stroke, she is at a higher risk for having a second stroke. Prior TIAs or heart attacks also increase a woman's risk for stroke.
• Smoking. Smoking contributes to the atherosclerosis process, which can lead to blood clots. A woman who smokes has a much higher risk for stroke. Women who smoke and use oral contraceptives also have a higher risk.
• High cholesterol. High levels contribute to the process of atherosclerosis and the formation of clots. Women who have high blood cholesterol levels are at high risk for stroke.
• High blood pressure. High blood pressure is a major cause of hemorrhagic stroke.
• Obesity. Women who are overweight or obese are at higher risk for stroke because obesity contributes to the development of high blood pressure and atherosclerosis.
• Diabetes. Women with diabetes are at much greater risk for a stroke than are women who do not have diabetes because diabetes contributes to the atherosclerosis process and the possibility of developing high blood pressure.
• Atrial fibrillation. In this heart rhythm disorder, the heart's upper chambers quiver instead of beating effectively, which can let the blood pool and clot, increasing the risk for stroke.
• Other types of heart or blood vessel disease. People with coronary artery disease or heart failure have a higher risk of stroke than those with hearts that work normally. People whose carotid arteries (the main blood vessels supplying the brain) that are narrowed by fatty deposits from atherosclerosis are also at increased risk.
• Poor diet. Diets high in saturated fats, trans fats, and cholesterol can raise blood cholesterol levels. Diets high in salt can raise blood pressure, while diets with excess calories can contribute to obesity. All of these factors can increase the risk of stroke.
• Alcohol or drug abuse. Excessive alcohol use and illicit drugs such as cocaine may increase your risk for a TIA or a stroke.
• Oral contraceptives. Birth control pills may slightly increase the risk for stroke. The risk increases greatly if a woman has diabetes, is obese, smokes, has high blood pressure, or is over age 35. Talk to your doctor if you use oral contraceptives and you have any of these other conditions.
• Hormone replacement therapy. The use of estrogen and progestin in hormone replacement therapy may slightly increase the risk for stroke.
• Migraines. Migraines or severe headaches are a risk factor for stroke, particularly in women under age 55.
• Autoimmune diseases. Diseases in which the immune system is overactive, such as lupus, can increase the risk of stroke.

How is a stroke treated?

The best treatment for stroke is prevention, experts say. That means modifying your lifestyle so that you reduce your risk for stroke.

If stroke symptoms occur, get immediate medical treatment. Early treatment can help prevent permanent neurological damage, especially in ischemic strokes. The longer a stroke is untreated, the greater the possibility of disability or death. Drug therapy is the most common treatment for stroke. Surgery also can be used to treat stroke or to repair damage to brain tissue.

Recovery from a stroke hinges on physical therapy or occupational therapy. This includes exercise and training to relearn everyday activities. Speech therapy also may be prescribed for patients who have difficulty with speech or written words.