Women Have Double the Risk of Mid-Life Stroke

Study counters the notion that men are most vulnerable

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HealthDay Reporter

WEDNESDAY, June 20, 2007 (HealthDay News) -- Twice as many American women than men are suffering strokes in middle age, a new study shows.

The trend may be largely due to increases in heart disease and weight gain among women, according to the report in the June 20 online edition of Neurology.

"In the age range of 45 to 54, women were more than twice as likely to report having had a stroke," said lead author Dr. Amytis Towfighi, of the Stroke Center and department of neurology at the University of California, Los Angeles.

The study also looked at what factors could be contributing to this increase in women having strokes. "We found that the independent predictors of stroke in women of that age group were coronary artery disease and waist circumference," Towfighi said.

The researchers also found that women have a steeper rise than men in several factors for heart disease and stroke, such as high blood pressure and high cholesterol.

"For example, while men's blood pressure raises four to five points each year in the mid-life years, women's blood pressure increases by eight to 10 points," Towfighi said.

In its study, the UCLA team collected data on 17,000 American women and men involved in the National Health and Nutrition Examination Survey. Among these adults, 606 reported having had a stroke.

The researchers found that women 45 to 54 years old were more than twice as likely as men in the same age group to have had a stroke. There were no differences in stroke rates found in the 35-to-44 and the 55-to-64 age groups, they noted.

Towfighi's group also found a greater than expected stroke rate among older middle-aged men. Men 55 to 64 were three times more likely than men 45 to 54 to have had a stroke. The reasons for this finding aren't yet clear, Towfighi said.

Medical care discrepancies may be driving much of the stroke "gender gap," Towfighi said. "Risk factors for women are not being as adequately controlled in middle-aged women," she said. "This might be because these women were not perceived to be at high risk for stroke, and also, a lack of awareness of controlling risk factors by women and primary-care physicians."

One expert was intrigued by the findings.

"These data certainly question what we previously thought of as fact -- that middle-aged men, simply by being men, are at greater risk of stroke," said Dr. Emil Matarese, spokesman for the American Heart Association/American Stroke Association and director of the Stroke Center at Saint Mary Medical Center in Langhorne, Penn. "But there is not enough data here to explain that disparity," he added.

However, stroke among middle-aged women is becoming a bigger problem as the society ages, Matarese said. "This is going to become a greater health-care crisis in our country with more women suffering strokes as they age than in the past," he said.

Matarese noted that other factors may boost the risk of stroke among middle-aged women, including reduced estrogen production, use of hormone replacement therapy and oral contraceptives, and an increase in migraines.

"This is a wake-up call for the health care community, regardless of whether the statistics here are adequate to make long term conclusions," Matarese said. "This is a wakeup call to start looking at women in a more aggressive manner and to start reducing their risk of heart attack and stroke."

More information

For more information on women and stroke, visit the American Heart Association.

SOURCES: Amytis Towfighi, M.D., Stroke Center and department of neurology, University of California, Los Angeles; Emil Matarese, M.D., national spokesman, American Heart Association/American Stroke Association, and director, Stroke Center, Saint Mary Medical Center, Langhorne, Penn.; June 20, 2007, Neurology, online

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