Stroke: Know the Warning Signs and How to Lower Your Risk

Most women don't, and new research shows doctors still aren't treating women as aggressively as men.

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When it comes to breast cancer, we all know to check for breast lumps and get mammograms after age 40. When it comes to protecting ourselves against strokes, however, most of us don't have a clue. A new study published in the American Heart Association's journal Stroke finds that fewer than 20 percent of women with atrial fibrillation (irregular heartbeat) and little more than 15 percent of women with heart disease recognize that they're at increased risk for having a debilitating or even deadly stroke. In fact, strokes are the third leading killer of women, behind heart disease and all cancers combined.

Attention must be paid. That's the message being sent out by the American Heart Association in devoting the entire April issue of Stroke to women and gender disparities in stroke care. The issue contains a slew of studies explaining some reasons that death rates for stroke in women haven't declined, even though they have for men. It turns out doctors still aren't treating female stroke patients as aggressively as males: Michigan State University researchers found that women were 14 percent less likely than men to receive all the appropriate workup and treatments that they needed in the hospital, such as clot-busting drugs and aspirin. Other research found that doctors treating women are less likely to use stroke prevention strategies like cholesterol-lowering drugs.

"There appears to be a delay in treatment when women hit the emergency room," says Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital and spokesperson for the AHA's "Go Red for Women" campaign. One of the complicating factors, she says, could be uncontrolled high blood pressure, which is more common in female stroke victims. Using clot-busting drugs or blood thinners could raise the risk of a brain hemorrhage, which can be more dangerous than a stroke caused by a blood clot. The reluctance to prescribe cholesterol-lowering drugs like statins in women could hearken back to the days when doctors mistakenly thought that lowering a woman's cholesterol raised her risk of a stroke. Or it could be due to the fact that up until recently, few statin research studies included women. Or perhaps women are more reluctant than men to take statins because of concerns about side effects like muscle pain. 

The answer? "Women need to think prevention and recognize the stroke warning signs," stresses Mosca. Unfortunately, "we're kind of where we were with heart disease a decade ago," she says. "We don't have the level of awareness that's optimal."

The American Stroke Association says to watch out for the sudden occurrence of one or more of the following symptoms and dial 911 immediately if you're experiencing them:

  • Numbness or weakness of the face, arm, or leg, especially on one side of the body
  • Confusion or trouble speaking or understanding
  • Vision problems in one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Severe headache with no known cause
  • To lower your risk of a stroke, just think good heart health. Maintain a healthy body weight, and reduce high blood pressure and cholesterol levels through medications and dietary changes. Here are some easy nutritional changes you can make to reduce your heart attack and stroke chances. Also, make it a point to assess your heart disease and stroke risks. And if you're over 35 and taking birth control pills or hormone therapy, talk to your doctor about whether you need to worry about an increase in your stroke risk.