For unknown reasons, women are at higher risk than men.
If you have coronary artery disease (CAD), you are at increased risk of having a heart attack. But many people don’t know that the same process that causes obstructive fatty plaques to accumulate in the heart’s arteries can occur in the brain’s arteries, increasing the risk for a stroke, or “brain attack.” Strokes occur in almost 800,000 people every year, affecting about 55,000 more women than men.
And CAD isn’t the only form of heart disease that increases the risk of stroke. So does atrial fibrillation (AF). AF increases the likelihood of forming a blood clot that can travel to the brain, where it can block the blood flow through an artery. For unknown reasons, older women with AF are at far higher risk of stroke than men, even when they have the same risk factors and are treated appropriately with the blood thinner warfarin (Coumadin), according to a study published in the May 9, 2012 issue of the Journal of the American Medical Association.
“It is interesting that the increase in risk began at age 75 in women. This infers that age and female gender are independent risk factors for stroke in AF,” says Dr. Paula Johnson, a cardiologist at Brigham and Women’s Hospital and an associate professor at Harvard Medical School.
How to lower your risk
The study suggests that warfarin might not be enough to prevent stroke in older women with AF. Until a better treatment is found, it’s more important than ever to take extra precautions to reduce your risk. This means keeping your weight, blood pressure, blood sugar, cholesterol, and triglycerides within a healthy range, not smoking, and getting daily exercise.
Recent studies have also found a lower rate of stroke among women who regularly consumed omega-3 fatty acids (primarily found in fatty fish), citrus fruits, and low-fat dairy products, so it wouldn’t hurt to add those foods to your diet.
If you have atrial fibrillation and are on warfarin, it is important to make sure that your blood is adequately thinned by following your blood test results. If you are 65 or older, you should also talk with your doctor about taking a daily baby aspirin, which has been shown to help prevent a first stroke in women.
For all women with heart disease, stroke prevention begins with awareness.
“If you are a woman without a history of heart disease, diabetes, or hypertension, tell your doctor if you experienced gestational diabetes or preeclampsia with a pregnancy, or have a family history of cardiovascular disease, since these conditions increase the risk of vascular disease, including stroke,” says Dr. Johnson. “Knowing you are at increased risk will enable you and your doctor to work together to prevent a stroke.”