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There’s still a misconception that it’s mostly men who suffer from stroke, yet women account for over half of all cases globally
MANILA, Philippines – In the Philippines, stroke is the third-leading cause of death and the leading cause of disability, regardless of gender.
Yet, there is still the notion that stroke only happens among men, a misplaced belief that somehow being a woman insulates one from suffering a stroke.
Women account for over half of all persons globally who experience stroke. Based on a Framingham Study in the United States, 1 in 5 women between the ages of 55 and 75 will have a stroke.
These data, admittedly, are alarming. But stroke is preventable. Among women, the distribution of risk factors is different from those of men.
Women need to know their risk factors and manage them accordingly to reduce their risk of stroke. A woman who has been smoking for 20 years, increases her risk factor by 12% for each increment of 5 cigarettes she smokes daily.
Stroke is an attack that happens when the blood flow to the brain is disrupted by either a clot or rupture of an artery or vein, causing brain cells to die from lack of oxygen and glucose.
This leads to potential damage or disability. There is a need to view stroke as a medical emergency because of its urgency and the expediency of its adverse impact. It comes unannounced — quick, stealthy, and potentially lethal — like a thief in the night that rummages the homes of victims.
It would help to be aware of the signs and symptoms of stroke which is encapsulated in the acronym BEFAST. This means loss of Balance, Eye or visual disturbance, Facial asymmetry, Arm and/or leg weakness, and Speech disturbance. If any of these symptoms occur, one should suspect a stroke and act fast because Time could spell the difference between life and death.
Treatments for stroke work best if given within 4.5 hours after the onset of symptoms. Time loss is brain loss, with every second leading to increasing probability of permanent damage to brain cells and even death.
How then should women protect themselves from stroke?
The only way is by judiciously controlling the risk factors which may vary among women.
The most common is hypertension, defined as having systolic/diastolic blood pressure of ≥ 140/90 mm Hg. Cases of hypertension in postmenopausal women actually exceeds that in men.
Studies have shown that the risk of stroke is higher by 25% for every 10 mm Hg increase in systolic blood pressure. That is why it is important to make sure that blood pressure is regularly monitored and a woman with hypertension complies with her antihypertensive medicines to maintain a target blood pressure of ≤ 140/90 at all times.
The prevalence of obesity is greater in women than in men. However, obesity is a risk factor for stroke in both genders. An active lifestyle and disciplined dieting have far-reaching benefits for women who would also be protecting themselves from Diabetes Mellitus, which if left uncontrolled poses a greater stroke risk with higher risk of death in women than in men.
Studies have likewise shown that Atrial Fibrillation (AF) or arrhythmia is associated with two- to four-fold higher risk of stroke in women than in men.
Arrhythmia is an irregularity or quivering of heartbeat which can result in clot formation leading to stroke and/or heart failure. The female sex is considered a risk factor for AF-related systemic thromboembolism such as stroke.
A sign that one already needs to consult a cardiologist immediately is when one feels some palpitations, easy fatigability, fluttering or “thumping” in the chest, dizziness, and generalized weakness.
Migraine is three times more likely to afflict women than men. About 20% to 30% of women ages 15-49 are hounded by migraine.
Migraine with aura is associated with an increased risk of ischemic stroke, especially among those women taking oral contraceptive pills and smokers.
The risk of stroke has reached even the bedrooms. Studies indicate that use of oral contraceptive pills (OCP) has 2.5-fold increased risk of ischemic stroke and 1.4-fold increased risk of hemorrhagic stroke.
In addition, endometriosis, which is a painful condition manifested as painful sex, severe cramps, heavy menstrual periods, and digestive or urinary symptoms, has 34% increased risk of stroke due to higher levels of estrogen that can promote clot formation.
There are other risk factors that women have to contend with, such as dyslipidemia and the use of oral menopausal hormone replacement therapy (HRT).
Stroke prevention in women can be challenging. There is a large population of women who are at risk for first-ever stroke, and their awareness of their risk factors may be low. Knowing one’s risk factors is the initial step to prevention of stroke. – Rappler.com
Dr. Ma. Cristina Macrohon-Valdez is the president of Stroke Society of the Philippines. She is the chief section of neurology at St. Luke’s Medical Center Quezon City and an active stroke neurology consultant of the Brain Attack Team for both St Luke’s Medical Center Global and Quezon City.
References:
- Cheryl Bushnell. 2009. Stroke Prevention in Women: Challenges and Opportunities. PubMedCentral. Curr Atheroscler Rep.2008 Aug: 10(4):347-353
- Parth Upadhyaya. 2024. First-time Stroke Prevention: What women should know. MedBlog. Brain;prevention; women’s health
- Cindy W. Yoon et al. 2023. Stroke in Women: A Review Focused on Epidemiology, Risk Factors, and Outcomes. Journal of Stroke 2023:25(1):2-15
