HealthONE - May 01, 2021

Every 40 seconds someone in the US has a stroke; every four minutes, stroke claims another life. While stroke affects both men and women, experts have found that it affects about 50,000 more women than men each year. In fact, one in five women has a stroke at some point in her life. And stroke causes twice as many female deaths as breast cancer and is the third leading cause of death among women. “One of the more obvious reasons for this disparity is that the risk of stroke increases with age and women live longer than men,” explains Ira Chang, MD, a neurologist at Swedish Medical Center. “However, there are other more controllable factors that put women at a higher risk than men. It is important for women to understand their unique risk and take action to reduce it.”

What is a stroke?

A stroke occurs in the blood vessels of the brain. When a blood vessel is blocked by a blood clot, or if the vessel bursts, the critical nutrients that blood carry are unable to reach a part of the brain. Without these nutrients, the cells of the affected area of the brain die, which can result in permanent brain damage or death.

“Time is so important when it comes to a stroke,” Dr. Chang emphasizes. “We have ways to open and repair vessels to preserve the brain, but these treatments must be administered within the first few hours of the event.”

What are the risk factors for strokes in women?

Risk factors unique to women are use of birth control medications, especially for women who smoke; pregnancy conditions such as preeclampsia and gestational diabetes; and hormone replacement therapy. “Preeclampsia is a dangerous spike in blood pressure during pregnancy,” Dr. Chang explains. “This not only puts women at a higher risk of stroke during pregnancy and in the immediate postpartum period—we also have found that it also doubles their risk for stroke later in life.” The common risk factors among men and women are age, high blood pressure, high cholesterol, obesity, diabetes, smoking, physical inactivity and substance abuse.

How can women reduce stroke risk?

“Possibly the most important way for anyone to reduce stroke risk is to quit smoking,” Dr. Chang implores. “There are many resources for people who need help to quit, including the Colorado QuitLine.” Dr. Chang also encourages women to take control of their blood pressure levels through healthy diet habits and to talk to a doctor about medications that can help.

Cholesterol levels can be reduced in the same way. “We know that eating right and getting exercise reduces our risk for many deadly conditions,” Dr. Chang says. “Reduce your salt intake, increase your fiber, increase your whole grains and get some form of exercise for 30 minutes every day. These simple steps work wonders for our health.” For women on birth control, taking hormone replacement therapy or have a history of preeclampsia, Dr. Chang suggests discussing risk with your doctor to determine if additional measures, such as aspirin use, might be helpful.

What are the warning signs of stroke in women?

Everyone should know the top warning signs of stroke, which can easily be remembered with the pneumonic device: FAST:

Face: Does the face look uneven?

Arm: Is one arm weak or numb?

Speech: Is the person’s speech slurred or difficult to understand?

Time: Call 9-1-1- now!

Additional warning signs for women include fainting, shortness of breath, hallucinations, confusion, sudden behavioral change, agitation, seizers, hiccups and nausea. “I cannot emphasize this enough: if you think you or someone you are with is having a stroke, call 9-1-1 right away,” Dr. Chang implores. “We have a stroke alert program so that when the ambulance picks up a patient who seems to be having a stroke, they call us. This triggers a ‘stroke alert’ for us. Immediately, our team assembles and meets the EMS team at the door. We then go immediately into care, wasting no time. This allows us to treat the stroke and preserve as much brain function as possible.”

To learn why more people are saying “Take me to Swedish!” for their stroke and emergency needs, visit us online at Swedish Hospital.

Ira Chang, MD, is a board-certified, fellowship-trained neurologist at Swedish Medical Center. Dr. Chang was born in Italy and raised in Maryland after immigrating to the United States from South Korea as a child. She received her undergraduate degree from Yale University. Dr. Chang moved to Colorado after finishing her medical training and stayed, practicing in outpatient neurology for several years. In 2005, she founded Blue Sky Neurology with a partner and has transitioned into the newly emerging fields of neurohospitalist and neurocritical care. Dr. Chang is the Medical Director of Neurocritical Care and has served for several years as Chairman of the Neurology Division, President of the Swedish Medical Staff and HealthOne President's Council.  She teaches neurology residents as an Assistant Clinical Professor at the University of Colorado Health Sciences Center. Dr. Chang also loves being a mom, skiing, and adventurous trips with her family.