Nearly 60 percent of the stroke deaths in the United States are women.One in 5 women in the United States will have a stroke in her lifetime.Women have a higher lifetime risk of stroke. Stroke is the fifth leading cause of death for men, but the third leading cause of death for women.
Not only is stroke more common in women compared with men, a preliminary study presented at the American Stroke Association’s International Stroke Conference 2019 found that women were less likely to receive the recommended evaluations and treatment after stroke. In the study, researchers looked at nearly 67,000 men and women Medicare beneficiaries with ischemic stroke and found that up to 10 percent of women hospitalized with stroke were less likely than men to receive imaging and other specialized tests to diagnose the cause of stroke, such as monitoring for heart rhythm irregularities and echocardiography, and were less likely to see a stroke specialist. “Anybody who has had a stroke should be evaluated by a neurologist, usually a vascular neurologist,” says Sam S. Bruce, MD, lead researcher of the study and a neurology resident at NewYork Presbyterian-Weill Cornell in New York City. “Heart rhythm monitoring, echocardiography, and vessel imaging are generally recommended as well.” Overall, the study found that women are likely to get a less intense medical workup after stroke than they should, compared with men, Dr. Bruce says. Being properly evaluated after stroke can lead to additional information that could impact your treatment and recovery.
How Stroke Symptoms Differ in Women vs. Men
Another study, published in July 2018 in the journal Lancet Neurology, found similar differences in how stroke is diagnosed and treated in women versus men. In both sexes, the most common symptoms of stroke are similar, including drooping on one side of the face, arm weakness, and slurred or strange speech. But compared with men, women can have more nontraditional stroke symptoms, says Cheryl D. Bushnell, MD, professor of neurology and stroke division chief at Wake Forest Baptist Health in Winston Salem, North Carolina. Untraditional stroke symptoms include loss of consciousness, generalized weakness (in addition to the more one-sided weakness typically associated with stroke), fatigue and confusion, or other changes in behavior, Dr. Bushnell says. Moreover, women are more likely to experience symptoms that mimic stroke. “Mimics of stroke commonly include migraine headaches with additional neurologic symptoms — such as weakness, numbness, and vision or speech changes — seizures, brain tumors, metabolic disturbances such as low blood sugar, or psychiatric conditions,” Bushnell says. Because of the increased likelihood that women experience nontraditional stroke symptoms and stroke mimics, doctors may not recognize stroke as quickly in women compared with men, Bushnell says. Consequently, it can take longer for women with a suspected stroke to undergo the appropriate brain imaging, which is the first step after arriving at the hospital emergency department to make a diagnosis and develop a stroke treatment plan. Meanwhile, time is brain. During a stroke, almost 2 million brain cells die every 60 seconds. But the faster you get diagnosed and treated, the more likely you are to recover from a stroke.
What Can You Do to Get Better Stroke Treatment?
These steps can help you or a loved one get the right medical care quickly to increase the odds of fully recovering from a stroke: In REDUCE-IT, a landmark study published in January 2019 in The New England Journal of Medicine, men and women with high triglycerides who were already taking statin medication to lower LDL (“bad”) cholesterol and added icosapent ethyl to their regimen reduced their risk of stroke by 28 percent. In the same study, it also reduced the risk of heart attack by 31 percent. The cardiovascular benefits were the same for both men and women, with few side effects. “Vascepa is one of the most exciting things that has happened in preventive cardiology in the last decade,” says Lori Mosca, MD, professor of medicine at NewYork-Presbyterian and Columbia University Medical Center.
