Wellness

What Women Should Know about Preventing Stroke

Photo courtesy of Anders Overgaard/Trunk Archive

What Women Should Know about Preventing Stroke

What Women Should Know
about Preventing Stroke

Stroke is the third leading cause of death for women—and more women die of stroke than men, according to the CDC. Those are the unpleasant facts. The somewhat good news: Up to 80 percent of strokes can be prevented. To the degree that we can control it, prevention is fairly simple, says Chicago-based neurosurgeon Dr. Sheri Dewan, one of only about 200 female neurosurgeons in the country. Refrain from smoking, eat well, move your body. And: Get your blood pressure checked regularly, folks!

A Q&A with Sheri Dewan, MD

Q
What are some evidence-based ways to prevent a stroke?
A

What we know of stroke prevention comes from extensive studies that have been performed in the medical literature. Key lifestyle modifications—such as refraining from smoking, maintaining a normal weight, eating healthy foods, and getting thirty minutes of exercise four to five times a week—are known preventive strategies to reduce risk.

Having elevated blood pressure, a condition known as hypertension, is a primary cause of stroke, so checking your blood pressure is less intuitive but extremely important. The ideal blood pressure for an individual is typically 120/80, with variations. Have your blood pressure checked in the physician’s office, with a recording of your initial screening. A lot of people have no idea what their normal blood pressure is—they can have an elevated blood pressure and not even know it. I encourage people who have been diagnosed with hypertension to buy a home blood pressure monitor to track daily readings.

Having high cholesterol, a condition called hypercholesterolemia, is another leading cause of stroke. Cholesterol can cause a clogging of the arteries that supply blood to the brain, leading to an interruption of blood flow. High cholesterol can be diagnosed through a blood test performed under the direction of your physician.


Q
What’s the connection between high blood pressure and stroke?
A

High blood pressure damages arteries throughout the body by weakening the arterial walls. Over time, the artery simply can’t handle the amount of pressure it’s getting on a constant, minute-by-minute basis, so the arterial wall can become stretched or weak. Think of the wall like a balloon stretched and worn over the years: When that happens, you can suffer a hemorrhagic stroke, or the artery can rupture or tear, which leads to bleeding inside the brain.


Q
Are there things that women in particular should know?
A

A lot of younger women don’t realize that oral contraceptives elevate their blood pressure. Studies show that the increased risk is small if no other stroke risk factors are present. It’s important to have your blood pressure screened accordingly. Smoking can increase this risk, so avoid smoking while on oral contraceptives.

Pregnancy-related complications can also occur, such as preeclampsia, a dangerous elevation of blood pressure, increasing stroke risk. Gestational diabetes and increased blood clots caused by decreased blood flow in the lower legs can lead to an elevated risk of stroke. These conditions should be monitored by a physician, who can decide when to intervene with low-dose aspirin, a blood-thinning medication.

If you look at the data published in the Journal of Neurology in 2017 on women’s stroke rates over the previous ten years, it shows men’s risk for stroke declined, but the risk for stroke in women did not. Women’s stroke rates have held steady. A number of factors are likely, including a lack of symptom education targeted to women.


Q
What are the symptoms that people should be aware of?
A

Classic symptoms for stroke are weakness in an arm or a leg. This could be temporary, lasting about a minute, or it could last for several hours. There can be drooping in the face with associated numbness or weakness. There can also be what’s called aphasia, where you have an interruption in your speech. In younger women, stroke can present as dizziness or a severe headache.


Q
If you’re experiencing any of those symptoms, what should you do?
A

If you’re experiencing any of these symptoms, call 911 or have someone call for you. With stroke, there is a time component: Some strokes happen because there’s a clot in the artery, and there are blood-thinning medications that can be given to break up the clot in the artery, which can prevent further harm.


Q
What’s the recovery process from a stroke?
A

Stroke is the fifth leading cause of death in the United States and the leading cause of disability. A stroke can lead to devastating loss of life or function. A lot of it depends on the severity of the stroke and the location in the brain. The location is responsible for the neurologic deficit: Strokes in the frontal lobe may affect speech, leading to an aphasia. Strokes in the motor cortex can cause weakness or paralysis in the arms or legs.

A stroke can be deadly, but it can also leave patients impaired, with disability in cognitive thinking or processing. In extreme cases, patients may need extensive rehab because of severe weakness on one side of the body, possibly be wheelchair-bound and unable to walk, or lose speech function—again, it depends on the location of the stroke in the brain.

If you’ve had a mild stroke, what we call a transient ischemic attack, symptoms can resolve quickly, but further monitoring is needed to provide long-term prevention. Your doctor may prescribe a medication to thin your blood so that it doesn’t recur.


Dr. Sheri Dewan is a board-certified neurosurgeon practicing in the Metro Chicago area, affiliated with Northwestern Medicine. She completed her residency at Brown University and is a board member of Women in Neurosurgery (WINS), the Congress of Neurological Surgeons, and the American Association of Neurological Surgeons. Dr. Dewan donates her time performing charity surgery in southern India through the AIMS hospital group and also sits on the board of Allendale Foundation, a charitable organization for foster children.


This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.

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