Stroke in women:  Risk factors unique to it are now identified


Stroke in women:  Risk factors unique to it are now identified
Lokesh S
Neurosurgery
Stroke in women:  Risk factors unique to it are now identified

Stroke in women:  Risk factors unique to it are now identified

India is currently facing the challenge of a high stroke incidence. Cardiovascular disease including stroke, which comprised 19% of death in India in 2001-2003, is estimated to rise to 36% by 2030. Stroke is one of the leading causes of death in India. The rates are especially higher among women, perhaps because women exhibit higher prevalence of uncontrolled hypertension than men.

What is stroke?

The common mode of expression of stroke is a sudden occurrence of a focal neurologic deficit. Strokes are broadly categorized as ischemic or hemorrhagic.

A) Ischemic stroke is due to occlusion of a cerebral blood vessel and causes cerebral infarction.

Common causes are: (i) atherosclerosis with superimposed thrombosis affecting large cerebral or extra cerebral blood vessels, (ii) cerebral embolism, and (iii) occlusion of small cerebral vessels within the parenchyma of the brain.

B) Haemorrhagic stroke: Haemorrhage, which occurs either within the substance of the brain or contained within the subarachnoid spaces and ventricular system.

Common risk factors for stroke are:

Modifiable risk factors:

  • High blood pressure
  • Smoking
  • Diabetes
  • High cholesterol
  • Physical inactivity and obesity
  • Carotid or other artery disease
  • Transient ischemic attacks
  • Atrial fibrillation or other heart disease
  • Certain blood disorders such as Sickle cell anaemia
  • Excessive alcohol intake

Non modifiable risk factors:

  • Increasing age
  • Gender
  • Heredity and race
  • Prior stroke

Recent study found risk factors unique to stroke in women:

Endogenous hormones

Early age at menarche (< 10 years)

Early age at menopause (< 45 years)

Exogenous hormones

Post menopausal hormonal therapy: oral estrogens,

Combined oral contraceptives

Pregnancy-related exposures

Pregnancy

Hypertension in pregnancy

Gestational diabetes mellitus

Image source:strokeconnection.strokeassociation.org