Women and stroke - special risks, worse prognosis

    OTTAWA, June 5 /CNW Telbec/ - Strokes kill 45% more women than men in
Canada, according to a new data analysis released today by the Heart and
Stroke Foundation. And that's why Canadian women have a strong reason to be
aware of the warning signs of stroke, says the Foundation.
    At all ages, a man has a higher risk of having a stroke than a woman. But
each year, more women than men die from stroke - and the gap is widening. In
1973, there were 8,523 female deaths from stroke compared to 7,702 male deaths
- a 10% difference. By 2004 (the latest year for which data are available),
female deaths increased to 8,667 while male deaths dropped to 5,959. Data
suggests that the lifetime risk for a middle-aged woman of having a stroke is
1 in 5, whereas it is 1 in 6 for a middle-aged man.
    Some of women's increased stroke risk is caused by the fact that women
tend to live longer on average than men, and stroke mortality is higher with
age. Most risk factors for stroke, such as high blood pressure, diabetes,
smoking, inactivity and high cholesterol, are the same for men and women, and
can be controlled. But new research is suggesting that there may be some risk
factors that are uniquely important for women.


    A review of the research shows that among women age 20-44 years of age,
those who have migraines have double the risk of stroke. More recently, a
study found that women who have migraines with visual disturbances such as
flashing dots or blind spots can be up to 10 times more likely to have a
    In the 2003 Canadian Community Health Survey, 15% of women age 30 and
over reported migraines, compared to only 6% of men.


    Pre-eclampsia is a form of pregnancy-associated high blood pressure that
occurs in about 5-7% of all pregnancies. Research suggests that women who
develop preeclampsia have a 60% greater risk of non-pregnancy-related ischemic
stroke, compared to women without a history of pre-eclampsia

    Hormone Replacement Therapy (HRT)

    The massive Women's Health Initiative has shown that although most women
who take HRT will not have a stroke, women who take estrogen and progestin HRT
for less than two years have a 40% higher risk. Although the risk drops after
two years, it is important that women who take or are considering HRT talk to
their doctors about both the benefits and the risks.

    Oral Contraceptives

    For most women, the risk of stroke from taking oral contraceptives (birth
control pills) is very small. However, for women who smoke, have high blood
pressure, migraines or blood clotting disorders, the risk is much higher.
Women who have these risk factors are advised to talk with their doctor before
taking oral contraceptives.
    Women also face other challenges related to stroke. "Compared with men,
women with stroke are more likely to live alone and less likely to have social
supports," notes Heart and Stroke Foundation researcher Dr. Moira Kapral.

    The good news

    The good news is that Canadian researchers are finding that women are not
only benefiting as much as men from new stroke treatments - they may even be
doing better. In an analysis of the PROACT study, a major study of
"clot-busting" therapy for acute ischemic stroke, neurologist and Heart and
Stroke Foundation spokesperson Dr. Michael Hill found that female stroke
patients benefited even more from this treatment than male patients.
    "Over the past decade there have been dramatic advances in therapies to
decrease death and disability from stroke," agreed Dr. Moira Kapral. "But some
studies suggest that some effective treatments are under-used in women, and we
need to do further research to find out why."
    Dr. Kapral is involved in the GENESIS project, a national
multidisciplinary research team looking at gender differences in heart disease
and stroke, which is funded by the Heart and Stroke Foundation and the
Canadian Institutes of Health Research.

    The bottom line

    The bottom line, stresses Dr. Hill, is that it is essential for all
Canadians to know the warning signs of stroke and to act immediately when they
occur. "Too many people hesitate before calling 9-1-1 or their emergency
number. But stroke is a medical emergency. The faster you can get to the
hospital, the quicker you can be treated and the greater the chances of
preventing permanent damage."
    The Heart and Stroke Foundation estimated that there are between 40,000
to 50,000 strokes in Canada each year, and 300,000 Canadians living with the
effects of stroke.
    According to the Heart and Stroke Foundation, of every 100 people who
have a stroke, approximately 15 will die, 10 will recover completely, 25 will
recover with a minor impairment or disability, 40 are left with a moderate to
severe impairment and 10 will be so severely disabled that they require
long-term care.

    The warning signs of stroke and what to do about them

    Weakness           Sudden loss of strength or sudden numbness in the
                       face, arm or leg, even if temporary.
    Trouble speaking   Sudden difficulty speaking or understanding or sudden
                       confusion, even if temporary.
    Vision problems    Sudden trouble with vision, even if temporary.
    Headache           Sudden severe and unusual headache
    Dizziness          Sudden loss of balance, especially with any of the
                       above signs
           Call 9-1-1 or your local emergency number immediately.

    Managing risk

    The leading risk factor for stroke is high blood pressure. Over 5 million
Canadians have high blood pressure, and of these 42% don't even know that they
have it. Over 21% of Canadian women 45-64 years of age have high blood
pressure, and nearly 48% of women age 65 or older have high blood pressure.
    The Heart and Stroke Foundation has developed resources to help Canadians
prevent and manage high blood pressure, including a free customized personal
action plan, which can be found at www.heartandstroke.ca/bp

    June is Stroke Month.

    The Heart and Stroke Foundation (www.heartandstroke.ca), a volunteer-based
health charity, leads in eliminating heart disease and stroke and reducing
their impact through the advancement of research and its application, the
promotion of healthy living, and advocacy.
    The Foundation is partnering with the Canadian Stroke Network on the
Canadian Stroke Strategy, a joint initiative to support an integrated approach
to stroke prevention, treatment and rehabilitation in every province and
territory by 2010. www.canadianstrokestrategy.ca

For further information:

For further information: or interviews with specialists and stroke
survivors: Jane-Diane Fraser, Heart and Stroke Foundation of Canada, (613)
569-4361 ext 273, jfraser@hsf.ca; For the media contact in your province, see
"contact us" under www.heartandstroke.ca/media

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