From the Guidelines
Women generally have a similar or higher risk than men for stroke starting around age 75-85. Before this age, men typically have a higher stroke risk, but as women age, their risk increases more rapidly and eventually surpasses men's risk. This shift occurs primarily due to women's longer life expectancy, which means more women survive to older ages when stroke risk is highest 1. Additionally, the loss of estrogen's protective cardiovascular effects after menopause contributes to this increased risk in older women. Other factors that specifically affect women's stroke risk include pregnancy-related complications like preeclampsia, use of certain hormonal contraceptives, and autoimmune disorders that are more common in women. Women also tend to have unique stroke symptoms that may be overlooked, such as confusion, fatigue, and general weakness, which can delay treatment. Some key points to consider:
- The risk of stroke in women is influenced by factors such as hypertension, diabetes, and obesity, which are becoming increasingly prevalent in women 1.
- Hormone replacement therapy may also play a role in stroke risk, with some studies suggesting an increased risk of stroke associated with estrogen-containing therapy 1.
- Regular blood pressure monitoring, maintaining a healthy lifestyle, and discussing hormone therapy risks with healthcare providers are important preventive measures for women as they age. It is essential to note that the risk of stroke in women can be reduced by addressing these factors and promoting a healthy lifestyle. By understanding the unique risks and factors that contribute to stroke in women, healthcare providers can better tailor prevention strategies and improve outcomes for women at risk of stroke 1.
From the Research
Stroke Risk in Women Compared to Men
- Women have a higher risk of stroke than men at older ages, specifically above 75 years 2, 3, 4.
- The risk of stroke is greater in women than in men among older patients admitted with recently diagnosed atrial fibrillation, regardless of warfarin use 2.
- Age-specific stroke rates are higher in men, but women have more stroke events due to their longer life expectancy and higher incidence of stroke at older ages 5, 3.
- Women are at a higher risk of death from subarachnoid hemorrhagic stroke, and this sex differential increases with age 3.
Age-Specific Stroke Risk
- Women under 65 years have a lower risk of stroke than men, but this risk reverses after age 85, with women being much more at risk 4.
- Ischemic stroke deaths are lower for women than for men aged 25-44 and 45-64 years, but higher for women above 65 years 3.
- The female-to-male mortality ratio differs for stroke subtypes by race/ethnicity and age 3.