Women: higher risk of stroke

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More women than men suffer stroke

Every year more women than men suffer a stroke. They also have additional risk factors that increase the risk of a stroke. These include taking birth control pills or migraine attacks.

Women have a higher risk of stroke According to the online portal “MyHandicap”, around 270,000 people suffer a stroke in Germany. Around 55 percent of them are women. The situation is similar in the USA, which is why two American specialist societies were forced to issue special guidelines for women on stroke prevention. In the demographics, there is a reason for the increased risk for women, as they get older and the risk of stroke increases with age. In Germany, women are on average 75 years old when they have a stroke and men are around 68 years old. General risk factors for both sexes are smoking, high alcohol consumption, little exercise, obesity or fat metabolism disorders. As the evaluation of studies showed, there are other circumstances for women in addition to age, which lead to the different numbers between the sexes.

Special recommendations for contraception For example, American doctors give prevention recommendations to younger women, for example, for contraception. Only after an examination for high blood pressure should young women be prescribed the contraceptive pill, since taking hormones in connection with hypertension has proven to be a special risk factor for stroke. Pregnant women with high blood pressure should even take a small dose of acetylsalicylic acid (e.g. aspirin) until birth to inhibit blood clotting. The majority of strokes are so-called ischemic cerebral infarctions, which result from poor circulation in the brain.

Migraines with aura Another factor that increases the risk of stroke in women is migraines. Although this is not a woman-specific disease, it occurs significantly more frequently in women than in men. The migraine with aura announces itself through perceptual disturbances or motor failures and those affected suddenly have the feeling of being blinded. Although this only slightly increases the risk, migraines with aura are associated with smoking. Therefore, it is not only American doctors who advise giving up smoking. Depression or emotional stress are also more important in women and increase their risk of stroke more than is the case in men.

Hormones during menopause Hormone replacement therapy has been controversial for a long time, as several studies have shown that hormones during menopause can increase the risk of breast cancer or heart attack, as well as thromboses and strokes. However, there are now fewer reservations about giving estrogens and progestogens, as experts now know that the risks vary from woman to woman. As the endocrinologist Christian J. Thaler, head of the hormone and fertility center at LMU in Munich told Spiegel, it has to be decided individually whether hormone therapy is necessary or not. Such therapy with low-dose hormones under medical supervision can be advantageous in the case of pronounced symptoms such as sleep disorders, violent sweating and depression that cannot be effectively treated with any other medication. In women with osteoporosis, however, the hormones are only one of several options.

Atrial fibrillation can increase risk by a factor of five. Apparently type 2 diabetes is also one of the factors influencing women, as a recent study in the medical journal "Diabetologia" shows. The scientists found that the disease only increased the risk of stroke in women: the higher the long-term sugar level HbA1c and the older the higher the risk. In addition, gestational diabetes is another female risk factor, because this leads to type 2 diabetes in about 50 percent of cases after pregnancy and thus increases the risk of stroke. Another gender difference is that atrial fibrillation is much more common in women than in men. The risk of stroke can be increased up to five times by the arrhythmia, in which blood clots can form in the heart. Women whose only risk factor for a stroke is atrial fibrillation would not have to take anticoagulant medication, usually over the age of 65. And even with successful treatment of atrial fibrillation, experts recommend permanent blood clotting using suitable medication, otherwise atrial fibrillation often recurs. (ad)

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