DEAR MAYO CLINIC: I read recently that stroke is one of the leading causes of death for women. I thought strokes mostly were a problem for men. Can you fill me in?

ANSWER: Ladies, the statistics are not in our favor. We need to take the risk of stroke seriously.

You’re not alone in your understanding of stroke risks for women. Many women underestimate their risk of stroke and believe that it mainly affects men. In reality, stroke is the fourth-leading cause of death for women. In the U.S. in 2021, 57% of stroke deaths occurred in women. According to the Centers for Disease Control and Prevention, about 1 in 5 women between the ages of 55 and 75 will have a stroke.

Each year, stroke kills nearly twice as many women as breast cancer.

Women’s risk factors for stroke

There are a few reasons why women are at higher risk. High blood pressure is a major factor, and nearly 40% of women have elevated blood pressure or are taking medication to keep their blood pressure under control.

Women also have a higher risk of stroke than men for reasons related to reproduction. Oral contraceptives, pregnancy and postmenopausal hormone therapy can all elevate women’s stroke risk. Women who develop preeclampsia, eclampsia or gestational diabetes while pregnant have a greater chance of stroke.

Depression is also a risk factor, and women have higher rates of this condition than men.

Stroke risk increases with age. Women, on average, live longer than men, so they’re at greater risk over their lifetimes.

Some groups of women, including African American and Hispanic women, are at even greater risk due to higher rates of high blood pressure, obesity and diabetes. For African American women, sickle cell disease is also a factor.

Other factors that raise a person’s stroke include heart disease, including abnormal heart rhythms like atrial fibrillation; smoking or tobacco use; and physical inactivity.

Know the warning signs

It’s important to learn the many warning signs of a stroke and seek emergency medical care immediately after the first symptoms appear.

Stroke symptoms appear suddenly. Here’s a saying and acronym to make recognizing and acting on these symptoms easy: “Think FAST.”

Other stroke symptoms may include:

You may be tempted to downplay symptoms and not want to go to the hospital. This feeling is normal, but it’s not a good idea. When care is delayed for someone having a stroke, the person’s brain is deprived of blood, oxygen and nutrients. Within minutes, brain cells start to die. Emergency medical care by experts trained in the diagnosis and treatment of stroke is necessary to preserve brain cells and, in the most serious cases, prevent death.

Time is critical with a stroke, so it’s usually best to call 911. Don’t try to drive yourself or ask someone to drive you to the emergency department. EMTs and ambulances have monitoring devices, medications and direct-to-the-emergency-department communications that can save your life and reduce damage.

Stroke treatment

More treatment options are available if you get to the emergency department quickly. Sometimes, medications can be administered through an IV to break up blood clots. The sooner the medications are given, the better. The medications are only effective if delivered within 4 1/2 hours from the start of symptoms. This time frame may be only three hours for specific patient populations, so it’s critical to seek medical evaluation as soon as symptoms start.

If a blood clot causes a stroke in a large artery, endovascular therapy may be necessary to remove the clot with a stent retriever. This intervention is also time sensitive.

Talk with your health care team about your own risk for stroke. Learn how to spot a stroke using FAST, and encourage people in your life to do so as well.

—Bayan Moustafa, D.O., Neurology, Mayo Clinic Health System, Eau Claire, Wisconsin

(Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. This Mayo Clinic Q&A represents inquiries this healthcare expert has received from patients. For more information, visit www.mayoclinic.org.)

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