Globally, stroke remained the second-leading cause of death and the third-leading cause of disability and death combined in 2019.
Recent studies indicate that stroke incidence in women is greater or comparable to that of males in younger age groups but afterward, men have a higher incidence of stroke than women in middle age. In an interview with HT Lifestyle, Dr Kranthi Mohan, Consultant Neurologist at Gleneagles Hospital in Bengaluru, shared, “The difference in stroke incidence between men and women narrows as the incidence increases in postmenopausal women. Eventually, stroke incidence in women is close to or even higher than in men in the eighth decade. It is generally considered that the LTR of stroke is higher in women than in men, mainly due to their longer life expectancy.”
Dr Kranthi Mohan highlighted the stroke risk factors that are specific to women -
2. Exogenous estrogen use of oral contraceptive pills (OCPs) is associated with an increased risk of stroke.In women with current OCP use were at a ≈2.5-fold increased risk of ischemic stroke and a ≈1.4-fold increased risk of hemorrhagic stroke.
3. Lifetime endogenous estrogen exposure
4. Atrial fibrillation: The prevalence of atrial fibrillation is higher in men, but the risk of stroke due to atrial fibrillation is higher in women.
5. Migraine
Migraine is more prevalent in women than in men.Migraine, particularly migraine with aura, is associated with an increased risk of ischemic stroke. Possible mechanisms explaining the migraine-stroke connection include genetic predisposition, endothelial dysfunction, coagulation abnormalities, arterial dissection, and paradoxical embolism via a patent foramen ovale (PFO).
Common risk factors:
Mortality and Morbidity in women with stroke :
a) Women have poorer functional recovery and lower quality of life (QOL) than men after stroke.
b) Post-stroke depression (PSD) is more common in women than in men.A previous systematic review suggested that the prevalence of PSD is 78% higher among women than among men.
c) Post stroke cognitive impairment and dementia is more prevalent in women than in men due to various factors.
Dr Kranthi Mohan concluded, “Women bear a disproportionate burden of stroke, being more susceptible to experiencing a stroke in their lifetime and facing poorer post-stroke outcomes. The risk factors specific to women for stroke are modifiable; therefore, early attention and prevention are crucial in both preventing and improving the prognosis of stroke.”