Why are women more at risk for stroke than men?
Dr. Eliza Miller: One of the main reasons the risk of stroke is higher in women than in men is because women on average live longer than men, and age remains a huge risk factor for stroke. The longer you live, the more time you have to have a stroke. The higher lifetime prevalence of stroke in women has often been attributed to that fact.
In the age groups that are 45 and up, men will have a higher risk of stroke. But in the younger group, it’s women who have a higher risk, especially during their reproductive years.
Why is the risk greater among younger women?
One reason may be that the incidence of high blood pressure in children and young adults has increased in recent years, and we know that high blood pressure has a stronger effect on stroke risk in women. “Normal” blood pressure for both men and women is defined as below 120 over 80. But the risk of stroke goes up almost immediately in women as soon as they are beyond 120, whereas in men it’s not until they hit 150.
Pregnancy is another factor that affects younger people. Pregnancy can nearly triple the risk of stroke in women, and pregnancy complications, like high blood pressure during pregnancy, gestational diabetes, preeclampsia, and blood clots, are associated with higher risk of stroke.
Why are Black women at even greater risk of stroke?
Studies have shown that African-American women have higher rates of high blood pressure, obesity, and diabetes than white women, as well as a higher risk of pregnancy-related complications.
Inequities across the social and economic spectrum, called the social determinants of health, also play a role in why Black women have higher stroke risk. If someone grows up with chronic stress and chronic discrimination, it can have a physiological effect on the body that leads to inflammation, increased stress hormones, and higher blood pressure. If you’re living in a world that is systemically set up to discriminate against you, it’s not surprising that your blood pressure might be higher. And if you don’t have access to regular care then you miss out on preventive care and are more likely to have uncontrolled diabetes, uncontrolled hypertension, or uncontrolled cholesterol, all of which will increase your risk of having a stroke at an earlier age.