Many risk factors for stroke are common to men and women, but certain risks are unique or at least more common in women.
In 2024, the American Heart Association and the American Stroke Association published modified directives and screening recommendations for women, in particular for those who:
Have been diagnosed with endometriosis
Experienced menopause before the age of 45
Experienced hypertension during their pregnancies
Ovarian function lost before the age of 40
The association recommends that health care providers exceed these conditions in the context of their risk assessment for a woman’s stroke.
Esturogen
Estrogens produced naturally in the body have a protective effect on cardiovascular health, including the risk of stroke.
But when estrogen is taken in oral contraceptives, as part of postmenopausic hormone therapy, or for any other reason, it increases blood coagulation factors, which can increase the risk of an ischemic stroke. While for most women, the use of oral contraceptives containing estrogens is safe, those who suffer from migraine with an aura, are over 35 years old, smoke cigarettes or who have other stroke risk factors, may be more at risk of stroke and should discuss the safety of oral contraceptives with their doctor.
In menopausal women, the normal decline in estrogen levels is associated with an increase in cardiovascular risk, including the risk of stroke.
Pregnancy
Pregnant women are three times more likely than women of the same age who are not pregnant to have a stroke, due to the increased risk of high blood pressure and blood clots during pregnancy.
Serious complications of pregnancy, gestational diabetes and preeclampsia – which causes high high blood pressure – also increase the risk of stroke.
Autoimmune conditions
Autoimmune diseases disproportionately affect women, and some of these diseases may increase the risk of stroke, due to the fact that they cause inflammation, which in turn causes the accumulation of plate in the arteries, the narrowing of blood vessels and blocking blood flow. Certain conditions may also increase the risk of blood clots.
Autoimmune conditions that may increase the risk of stroke include:
Migraine with aura
Migraine is another condition that affects more women than men, and migraine with an aura, in particular, is associated with a slightly higher risk of stroke, although scientists do not know exactly why.
Experts recommend that women who suffer from migraine with will have an effort to reduce all other risk factors for stroke they may have, including smoking, high blood pressure and obesity.
Race
The breed can increase the risk of stroke for certain women.
Research has shown that black women can be more at risk of stroke than white women of the same age. In a recent study, black women who received a diagnosis of high blood pressure before the age of 45 had twice as much risk of stroke. In addition, the results have shown that black women suffering from high blood pressure before the age of 35 had three times the risk of a stroke.
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