Stroke risk factors unique to women identified

February 8, 2018, Brigham and Women's Hospital
A blood clot forming in the carotid artery. Credit: copyright American Heart Association

Stroke disproportionately affects more women than men. It is the third leading cause of death in women in the United States, is a leading cause of disability and affects 55,000 more women than men each year. Investigators from Brigham and Women's Hospital and their colleagues are exploring the effects of potential risk factors that are unique to women, including hormone levels, hormone therapy, hormonal birth control, pregnancy and time of menarche and menopause. In a paper this week in Stroke as part of a special issue focused on women's health in honor of the American Heart Association's Go Red month, the team highlights risk factors with strong support in the scientific literature as well as important areas where future research needed, including the effects of hormone therapies for transgender people.

"Many people don't realize that suffer stroke more frequently than men, and mortality is much higher among women. As women age, they are much more likely to have a stroke as a first manifestation of cardiovascular disease rather than heart attack," said corresponding author Kathryn Rexrode, MD, MPH, of the BWH Department of Medicine. "We want to better understand susceptibility: why do more women have strokes than men? What factors are contributing and disproportionately increasing women's risk?"

Rexrode led a team that delved into the to investigate evidence about that are unique to women. Rexrode is also the co-author of a companion paper that examines sex differences among modifiable risk factors and preventative measures. In the systematic review led by Rexrode, the researchers report on several factors that elevate stroke risk among women including:

  • Early age of menarche (less than 10 years old)
  • Early age at menopause (less than 45 years old)
  • Low levels of the hormone dehydroepiandrosterone (DHEAS)
  • Taking oral estrogen or combined oral contraceptives

The team notes that while many of these factors are extremely common - only a fraction of women who have one or more will have a stroke in their lifetimes. However, Rexrode emphasizes that it is important for clinicians to consider these factors and others - including women who have a history of pregnancy complications including gestational diabetes, pre-eclampsia or hypertension during or immediately following pregnancy.

"These women should be monitored carefully and they should be aware that they are at higher risk, and motivated to adhere to the healthiest lifestyle behaviors to decrease the risk of hypertension and subsequent ," Rexrode said.

Certain risk factors - such as taking transdermal estrogen or progestogen-only contraception - need further research, according to the authors. The team also conducted a search of the literature for studies on unique to transgender people, but report that data on the effects medical treatment with estrogens, anti-androgens, or a combination of both is scant. Research on how to decrease risk among women with a history of pregnancy complication is another area ripe for additional research.

Explore further: Starting periods before age of 12 linked to heightened risk of heart disease and stroke

Related Stories

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

Risk of cardiac and stroke death increases after discontinuing hormone therapy

November 8, 2017
Hormone therapy (HT) continues to be a hotly debated topic. The benefits of estrogen to the heart, however, appear to be universally accepted. A new study demonstrates that the risk of cardiac and stroke death actually increases ...

Additional studies needed to evaluate CVD risks of hormone therapy for transgender patients

July 24, 2017
A new narrative review authored by Carl Streed Jr., MD, at Brigham and Women's Hospital, published in the Annals of Internal Medicine, discusses how more research is needed to better understand cardiovascular disease (CVD) ...

How does pregnancy affect risk of stroke in older, younger women?

October 24, 2016
Younger pregnant women, including the postpartum period up to six weeks after delivery, appeared to be at increased risk of stroke compared with their nonpregnant counterparts, and that increased stroke risk was not associated ...

Guidelines issued for stroke prevention in women

June 17, 2014
(HealthDay)—New guidelines have been released that highlight unique stroke risk factors for women and address prevention strategies, according to a synopsis article published in the June 17 issue of the Annals of Internal ...

Hypertension during pregnancy may affect women's long-term cardiovascular health

August 18, 2017
Women who experience hypertension during pregnancy face an increased risk of heart disease and hypertension later in life, according to a new study.

Recommended for you

Beetroot juice supplements may help certain heart failure patients

February 22, 2018
Beetroot juice supplements may help enhance exercise capacity in patients with heart failure, according to a new proof-of-concept study. Exercise capacity is a key factor linked to these patients' quality of life and even ...

Heart researchers develop a new, promising imaging technique for cardiac arrhythmias

February 22, 2018
Every five minutes in Germany alone, a person dies of sudden cardiac arrest or fibrillation, the most common cause of death worldwide. This is partly due to the fact that doctors still do not fully understand exactly what ...

Scientists use color-coded tags to discover how heart cells develop

February 22, 2018
UCLA researchers used fluorescent colored proteins to trace how cardiomyocytes—cells in heart muscle that enable it to pump blood—are produced in mouse embryos. The findings could eventually lead to methods for regenerating ...

'Beetroot pill' could help save patients from kidney failure after heart X-ray

February 22, 2018
Beetroot may reduce the risk of kidney failure in patients having a heart x-ray, according to research led by Queen Mary University of London.

Women once considered low risk for heart disease show evidence of previous heart attack scars

February 20, 2018
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart ...

Can your cardiac device be hacked?

February 20, 2018
Medical devices, including cardiovascular implantable electronic devices could be at risk for hacking. In a paper publishing online today in the Journal of the American College of Cardiology, the American College of Cardiology's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.