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June 2015

More strokes for men; more deadly for women

Dr. Stephanie Coulter

We’ve now moved beyond May, National Stroke Month, but guess what? Stroke risks don’t keep a calendar. We’re all at risk, even when our attention is turned away.
 
Women are also less knowledgeable about their risk factors and don’t perceive themselves at risk for stroke.

But, make no mistake, a stroke is always a medical emergency and remains the third leading cause of death for women.
 
And here’s a sobering statistic -- every year, stroke causes twice as many deaths in women as deaths due to breast cancer. 
 
Even if not deadly, strokes can be devastating, disfiguring and disabling. However, the good news is that early treatment will minimize brain damage and potential complications.

What are the causes of stroke?

A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. There are two main types of strokes–ischemic and hemorrhagic. Most strokes (about 85%) are caused by blocked vessels (ischemic stroke) and the other 15% are caused by bleeding, leaking or bursting vessels (hemorrhagic stroke.)

Some women may also present only with a temporary disruption of blood flow to their brain; known as transient ischemic attack (TIA). These usually lasts 5 minutes or less displaying symptoms similar to those of a have in a stroke. A TIA doesn't leave lasting symptoms because the blockage is temporary. But even if your symptoms resolve, take them seriously and see your doctor immediately, because a TIA elevates your risk of having a stroke, which may cause permanent damage. Learn more about the types of strokes here.

What are the symptoms of a stroke?
 
It is important to recognize the signs of stroke because prompt diagnosis and treatment may be the difference between life, death or further complications.
  • Sudden weakness or numbness in the face, arm, or leg on one side of the body.
  • Sudden trouble with speaking and understanding (confusion, slurred words, difficulty understanding speech).
  • Sudden trouble seeing with one or both eyes (especially in one eye), you may see double.
  • Unexplained dizziness or sudden falls.
  • Sudden trouble walking, loss of balance or coordination, possibly accompanied by vomiting, nausea, fever, hiccups or trouble swallowing.  
  • Sudden and severe headache with no other cause.
  • Brief loss of consciousness.
Although symptoms may appear slowly or suddenly, the underlying conditions that lead to stroke are usually present for years before a stroke happens.
 
What are the risk factors for a stroke?
 
As we get older our risk of stroke increases. Although men are at higher risk of stroke—women suffer from stroke much later in age, making them more prone to die from stroke. African-Americans in general have higher risk of stroke.

Non modifiable risk factors (things we cannot change):
  • Age 55 or older.
  • Race — African-Americans have a higher risk of stroke than do people of other races.
  • Gender — Men present a higher risk of stroke than women. But women suffer of stroke in older ages making them more prone to die from stroke than are men.
Life style risk factors (things we CAN change)
  • Smoking, (including second hand smoking)
  • Being overweight (BMI>25) or obese (BMI>30)
  • Lack of cardiovascular exercise
  • Heavy or binge drinking
  • Use of illicit drugs including cocaine and methamphetamines
Medical risk factors (things we CAN change)
  • High blood pressure (>120/80mmHg)
  • High cholesterol (Total cholesterol >200, LDL >130, Triglycerides >150)
  • Diabetes mellitus
  • Family history of stroke and/or cardiovascular disease, including heart failure, heart defect, heart infection and abnormal heart rhythm
Risk factors unique to women include:
  • Suffering from migraine headaches with aura (symptoms you feel shortly before the migraine begins, such as nausea).
  • Taking birth control pills. Combined with risk factors, such as age, cigarette smoking, pregnancy.
  • Hormone Replacement Therapy (HRT), any estrogen with or without progesterone to relieve menopausal symptoms (pill, bioidenticals) or testosterone.
One way you can improve your odds of avoiding a stroke is to learn about certain lifestyle changes and, if necessary, medications you can take to lower your stroke risk.

When to Look for Medical Attention

If you experience or notice any of the typical or atypical signs or symptoms in you or your loved one, seek immediately for medical help— even if they fluctuate.
 
Think FAST and recognize a 

stroke in time.Act "FAST" and call 911 or your local emergency number. Don't wait to see if symptoms go away. Every minute counts.
 
The longer a stroke goes untreated, the greater the potential for brain damage and disability. Treatment is critical and varies depending on the type of stroke you have suffered.

If you have already suffered a stroke, your treatment will also focus on preventing another stroke. This may include:
  • Maintaining a normal blood pressure. High blood pressure, is the most common risk factor for having a stroke, taking your medicines to lower or prevent hypertension and making changes to your diet and daily activities will help you make the difference.
  • Control your diabetes. Keep blood sugar levels within normal range by having a healthy diet, exercise and being compliant with your diabetes medication.
  • Taking aspirin or anticoagulants prescribed by your physician.
  • Quit smoking if you haven’t yet.
  • Avoid Hormone Replacement Therapy.
If you have suffered a stroke, a rehabilitation program may help to recover faster and you should not be ashamed to seek help. Like all other health conditions, it is always best to be involved and compliant with your care, the more you participate the better you will improve.

Until next time!

Dr. Stephanie signature
Stephanie Coulter, MD

Further reading:

Stroke
Metabolic Syndrome
Risk Factors for Women

Read past issues of Straight Talk.


Do you have a topic that you would like to learn more about from Dr. Stephanie? Send us an email at women@texasheart.org and your question may be the next Straight Talk topic!

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Visit the Center for Women's Heart & Vascular Health at www.texasheart.org/women.

 
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