Ischemic strokes, characterized by blood clots blocking brain arteries, account for 87 percent of all strokes. Recent analysis reveals that women under 35 may face a higher likelihood of experiencing this type of stroke than men. Moreover, women who survive ischemic strokes tend to encounter more challenging recoveries than their male counterparts.
A comprehensive review of 16 international stroke studies indicates that young women under 35 are 44 times more susceptible to ischemic strokes than men of the same age group.
It is essential to note that while conventional wisdom might suggest a higher stroke risk for men, ischemic strokes appear to affect young women each year disproportionately. The exact reasons for this trend remain unclear, but cardiologists speculate that factors such as oral contraceptives, pregnancy, and childbirth may influence the likelihood of stroke in young women.
Dr. Hoang Nguyen, an interventional cardiologist at MemorialCare Heart & Vascular Institute in Fountain Valley, California, reports an uptick in young individuals, particularly women, presenting with heart attacks and strokes. Women often exhibit atypical signs of heart attacks, which may also extend to stroke symptoms.
“This article highlights an observation many healthcare professionals have made based on clinical experience. Further research is necessary to expand our understanding of ischemic strokes in younger women and enhance clinical outcomes,” remarked Nguyen to Healthline.
Common stroke symptoms in women may encompass:
- Nausea or vomiting
- Seizures
- Hiccups
- Difficulty breathing
- Pain
- Fainting or loss of consciousness
- General weakness
Recognizing these symptoms is crucial for prompt medical attention in suspected stroke cases.
Young Women Exhibit Higher Stroke Rates Compared to Young Men
Researchers analyzed 16 studies from 2008 to 2021 to investigate the prevalence of strokes among individuals of different age groups, focusing on gender disparities.
The study encompassed a cohort of 69,793 young adults, comprising 33,775 women and 36,018 men.
Results revealed that the divergence in stroke occurrence between genders was most notable in the younger adult population, particularly those under 35.
Young women exhibited a staggering 44-fold higher likelihood of experiencing ischemic strokes when compared to their male counterparts.
Furthermore, women who survived ischemic strokes faced a 2 to 3 times higher risk of encountering challenging functional outcomes than men who had experienced similar strokes.
The authors of the study suggest that additional research is imperative to gain a deeper understanding of how factors such as pregnancy, postpartum conditions, and hormonal contraceptives contribute to the overall stroke risk in young women.
Dr. Hardik Amin, a neurologist and stroke specialist at Yale Medicine, as well as the medical stroke director at Yale New Haven Hospital’s St. Raphael Campus, emphasized the importance of this research, stating, “While the incidence of stroke in young patients remains significantly lower compared to older patients, this new data indicates that young women may face a heightened stroke risk in comparison to men of similar age.
We recognize that pregnancy and oral contraceptives can increase the risk of blood clots leading to strokes. Still, there appear to be additional nontraditional risk factors in this demographic that warrant further investigation.”
Impact of Pregnancy, Childbirth, and Oral Contraceptives on Stroke Risk
Dr. Nguyen suggests that the heightened likelihood of stroke in young women may be linked to oral contraceptives.
“Oral contraceptives have the potential to induce blood clots in the veins, which can then migrate to the right side of the heart,” explains Nguyen. Complications may arise when abnormal communication exists between the right and left sides of the heart.
Pregnancy is another factor that could contribute to stroke risk in women. Preeclampsia, a condition characterized by severe hypertension during pregnancy, can lead to strokes.
Moreover, pregnancy induces significant changes in the immune system. Nguyen points out, “This substantial shift in proinflammatory and anti-inflammatory mediators could potentially elevate the risk of strokes among younger women.”
Dr. Amit Mahajan, Chief of Neuro CT/MR and Head and Neck Imaging at Yale Medicine (section of neuroradiology), underscores the need for further research into ischemic strokes. Many believe that atherosclerotic disease accounts for the majority of strokes. However, racial and genetic factors and congenital anomalies may also contribute to an individual’s stroke risk. Importantly, the stress associated with enduring racism and racist systems could play a role in disease development, potentially beyond genetic factors.
Mahajan emphasizes that most ischemic strokes remain cryptogenic, meaning the cause is unknown. This underscores the importance of intensified efforts to identify the underlying causes of these strokes.
What Causes Poorer Outcomes for Women?
The study reveals that women who survive strokes frequently encounter challenging health outcomes and struggle with long-term functioning more often than men. However, the underlying reasons for this disparity remain unclear.
Dr. Nguyen speculates that a diagnostic bias may be at play, given the traditional medical advice that suggests men, particularly older men, are at a greater risk of stroke than women. Such a bias could result in delayed diagnosis and treatment for younger women, potentially explaining the poorer outcomes they experience.