Why do women suffer more strokes?

Before I became a physician, I used to think that heart attacks and strokes were problems for men, and that the only thing women had to worry about was breast cancer.

Then, during my training, I learned that a significant number of women would come to the hospital with strokes, and overall they tend not to recover as well. Looking at the literature, of the 700,000 strokes that occur per year in the United States, about 370,000 occur in women. Furthermore, of the 180,000 people who die from stroke each year, more than 100,000 of them are women. This number is much higher than breast cancer-related deaths (about 39,000).

So the question is: why the discrepancy? Well, the real answer is … we aren’t sure.

But there are many theories for this discrepancy that are being investigated. For starters, women overall tend to live longer than men, and stroke risk increases as we get older. Therefore, by simple math, women have more strokes.

This, however, doesn’t explain why women (without acute treatment) recover less favorably than men with similar types of stroke. Some of the theories include differences in blood vessel diameter (men being larger than women), as well as gender differences in cellular physiology (estrogen in females, for example).  There continues to be much research on this topic. But whatever the cause might be, it doesn’t change the reality that we all should realize: stroke is hardly only a male disease.

So women should understand overall risk factors for stroke, and some special considerations for women:

• Risk factors that increase your chances of having a stroke include high blood pressure, heart disease, smoking, diabetes and high cholesterol. Women should regularly monitor their blood pressure, cholesterol and other health factors, and should stop smoking if they smoke.

• some studies have shown hormone replacement therapy in post menopausal women can increase the risk of stroke. Women should talk to their doctors about the therapy and any risks.

While we aren’t sure why women are more likely to suffer a stroke, we do know these tips can help women decrease their risk of stroke and aid in their chance for a long and healthy life.

Hormozd Bozorgchami, M.D.
Instructor, Oregon Stroke Center
OHSU Brain Institute

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