Skip to main content

Stroke Risk Factors in Women

  • Chapter
  • First Online:
Neurology and Psychiatry of Women

Abstract

Stroke is the leading cause of acquired adult disability worldwide and the fourth leading cause of death in women in developed countries. Approximately 60% of stroke deaths occur in women. Women have a number of unique risk factors for stroke, including pregnancy and its related complications, duration of reproductive life, use of oral contraceptives and postmenopausal hormone therapy. Furthermore, the prevalence of traditional stroke risk factors and the strength of their association, varies by sex. Prior to stroke, women who develop stroke more commonly have atrial fibrillation, hypertension and migraine while men with stroke are more likely to have coronary artery and peripheral vascular disease. In this chapter we will focus specifically on risk factors for stroke in women.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 79.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organization. The top 10 causes of death worldwide 2017. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/.

  2. Leading causes of death in females. In: Centers for Disease Control and Prevention Website [online]. Available at: cdc.gov/women/lcod/index.htm. Accessed 28 Jan 2018.

  3. Leading causes of death in males: United States. In: Centers for Disease Control and Prevention Website [online]. Available at: cdc.gov/men/lcod/2013/index.htm. Accessed 20 Apr 2017.

  4. Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Au R, Kannel WB, et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke. 2006;37(2):345–50.

    Article  PubMed  Google Scholar 

  5. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Reeves MJ, Bushnell CD, Howard G, Gargano JW, Duncan PW, Lynch G, et al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol. 2008;7(10):915–26.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Leening MJ, Ferket BS, Steyerberg EW, Kavousi M, Deckers JW, Nieboer D, et al. Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population based cohort study. BMJ. 2014;349:g5992.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Madsen TE, Khoury J, Alwell K, Moomaw CJ, Rademacher E, Flaherty ML, et al. Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study. Neurology. 2017;89(10):990–6.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Koton S, Rexrode KM. Trends in stroke incidence in the United States. Will women overtake men? Neurology. 2017;89(10):982–3.

    Article  PubMed  Google Scholar 

  10. Koton S, Telman G, Kimiagar I, Tanne D. Gender differences in characteristics, management and outcome at discharge and three months after stroke in a national acute stroke registry. Int J Cardiol. 2013;168(4):4081–4.

    Article  PubMed  Google Scholar 

  11. Kittner SJ, Stern BJ, Feeser BR, Hebel R, Nagey DA, Buchholz DW, et al. Pregnancy and the risk of stroke. N Engl J Med. 1996;335(11):768–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, et al. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(5):1545–88.

    Article  PubMed  Google Scholar 

  13. Scott CA, Bewley S, Rudd A, Spark P, Kurinczuk JJ, Brocklehurst P, et al. Incidence, risk factors, management, and outcomes of stroke in pregnancy. Obstet Gynecol. 2012;120(2 Pt 1):318–24.

    Article  PubMed  Google Scholar 

  14. Bushnell CD, Jamison M, James AH. Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ. 2009;338:b664.

    Article  PubMed  PubMed Central  Google Scholar 

  15. James AH, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol. 2005;106(3):509–16.

    Article  PubMed  Google Scholar 

  16. Berends AL, de Groot CJ, Sijbrands EJ, Sie MP, Benneheij SH, Pal R, et al. Shared constitutional risks for maternal vascular-related pregnancy complications and future cardiovascular disease. Hypertension. 2008;51(4):1034–41.

    Article  CAS  PubMed  Google Scholar 

  17. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631–44.

    Article  PubMed  Google Scholar 

  18. Smith GN, Pudwell J, Walker M, Wen SW. Ten-year, thirty-year, and lifetime cardiovascular disease risk estimates following a pregnancy complicated by preeclampsia. Can: JOGC = J Obstet Gynecol Can: JOGC. 2012;34(9):830–5.

    Article  Google Scholar 

  19. McDonald SD, Malinowski A, Zhou Q, Yusuf S, Devereaux PJ. Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses. Am Heart J. 2008;156(5):918–30.

    Article  PubMed  Google Scholar 

  20. Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335(7627):974.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Brown MC, Best KE, Pearce MS, Waugh J, Robson SC, Bell R. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013;28(1):1–19.

    Article  PubMed  Google Scholar 

  22. Timpka S, Stuart JJ, Tanz LJ, Rimm EB, Franks PW, Rich-Edwards JW. Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses’ Health Study II: observational cohort study. BMJ. 2017;358:j3024.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Romundstad PR, Magnussen EB, Smith GD, Vatten LJ. Hypertension in pregnancy and later cardiovascular risk: common antecedents? Circulation. 2010;122(6):579–84.

    Article  PubMed  Google Scholar 

  24. Tobias DK, Stuart JJ, Li S, Chavarro J, Rimm EB, Rich-Edwards J, et al. Association of history of gestational diabetes with long-term cardiovascular disease risk in a large prospective cohort of US women. JAMA Intern Med. 2017;177(12):1735–42.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fadl H, Magnuson A, Ostlund I, Montgomery S, Hanson U, Schwarcz E. Gestational diabetes mellitus and later cardiovascular disease: a Swedish population based case-control study. BJOG: Int J Obstet Gynaecol. 2014;121(12):1530–6.

    Article  CAS  Google Scholar 

  26. Peters SA, Woodward M. Women’s reproductive factors and incident cardiovascular disease in the UK Biobank. Heart. 2018;104:1069–75.

    Article  CAS  PubMed  Google Scholar 

  27. Tanz LJ, Stuart JJ, Williams PL, Rimm EB, Missmer SA, Rexrode KM, et al. Preterm delivery and maternal cardiovascular disease in young and middle-aged adult women. Circulation. 2017;135(6):578–89.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ley SH, Li Y, Tobias DK, Manson JE, Rosner B, Hu FB, et al. Duration of reproductive life span, age at menarche, and age at menopause are associated with risk of cardiovascular disease in women. J Am Heart Assoc. 2017;6(11):e006713.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lidegaard O, Lokkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012;366(24):2257–66.

    Article  CAS  PubMed  Google Scholar 

  30. Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA. 2000;284(1):72–8.

    Article  CAS  PubMed  Google Scholar 

  31. Chan WS, Ray J, Wai EK, Ginsburg S, Hannah ME, Corey PN, et al. Risk of stroke in women exposed to low-dose oral contraceptives: a critical evaluation of the evidence. Arch Intern Med. 2004;164(7):741–7.

    Article  PubMed  Google Scholar 

  32. Peragallo Urrutia R, Coeytaux RR, McBroom AJ, Gierisch JM, Havrilesky LJ, Moorman PG, et al. Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis. Obstet Gynecol. 2013;122(2 Pt 1):380–9.

    Article  CAS  PubMed  Google Scholar 

  33. Baillargeon JP, McClish DK, Essah PA, Nestler JE. Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab. 2005;90(7):3863–70.

    Article  CAS  PubMed  Google Scholar 

  34. Chakhtoura Z, Canonico M, Gompel A, Thalabard JC, Scarabin PY, Plu-Bureau G. Progestogen-only contraceptives and the risk of stroke: a meta-analysis. Stroke. 2009;40(4):1059–62.

    Article  CAS  PubMed  Google Scholar 

  35. Kemmeren JM, Tanis BC, van den Bosch MA, Bollen EL, Helmerhorst FM, van der Graaf Y, et al. Risk of arterial thrombosis in relation to oral contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke. Stroke. 2002;33(5):1202–8.

    Article  PubMed  Google Scholar 

  36. Slooter AJ, Rosendaal FR, Tanis BC, Kemmeren JM, van der Graaf Y, Algra A. Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke. J Thromb Haemost. 2005;3(6):1213–7.

    Article  CAS  PubMed  Google Scholar 

  37. Grodstein F, Manson JE, Stampfer MJ, Rexrode K. Postmenopausal hormone therapy and stroke: role of time since menopause and age at initiation of hormone therapy. Arch Intern Med. 2008;168(8):861–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Grodstein F, Manson JE, Colditz GA, Willett WC, Speizer FE, Stampfer MJ. A prospective, observational study of postmenopausal hormone therapy and primary prevention of cardiovascular disease. Ann Intern Med. 2000;133(12):933–41.

    Article  CAS  PubMed  Google Scholar 

  39. Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the women’s health initiative randomized controlled trial. JAMA. 2004;291(14):1701–12.

    Article  CAS  PubMed  Google Scholar 

  40. Hendrix SL, Wassertheil-Smoller S, Johnson KC, Howard BV, Kooperberg C, Rossouw JE, et al. Effects of conjugated equine estrogen on stroke in the Women’s Health Initiative. Circulation. 2006;113(20):2425–34.

    Article  CAS  PubMed  Google Scholar 

  41. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–33.

    Article  CAS  PubMed  Google Scholar 

  42. Renoux C, Dell’aniello S, Garbe E, Suissa S. Transdermal and oral hormone replacement therapy and the risk of stroke: a nested case-control study. BMJ. 2010;340:c2519.

    Article  PubMed  Google Scholar 

  43. Rossouw JE, Prentice RL, Manson JE, Wu L, Barad D, Barnabei VM, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007;297(13):1465–77.

    Article  CAS  PubMed  Google Scholar 

  44. Viscoli CM, Brass LM, Kernan WN, Sarrel PM, Suissa S, Horwitz RI. A clinical trial of estrogen-replacement therapy after ischemic stroke. N Engl J Med. 2001;345(17):1243–9.

    Article  CAS  PubMed  Google Scholar 

  45. Clarke SC, Kelleher J, Lloyd-Jones H, Slack M, Schofiel PM. A study of hormone replacement therapy in postmenopausal women with ischaemic heart disease: the Papworth HRT atherosclerosis study. BJOG: Int J Obstet Gynaecol. 2002;109(9):1056–62.

    Article  CAS  Google Scholar 

  46. Merikangas KR. Contributions of epidemiology to our understanding of migraine. Headache. 2013;53(2):230–46.

    Article  PubMed  Google Scholar 

  47. Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017;16(1):76–87.

    Article  CAS  PubMed  Google Scholar 

  48. Champaloux SW, Tepper NK, Monsour M, Curtis KM, Whiteman MK, Marchbanks PA, et al. Use of combined hormonal contraceptives among women with migraines and risk of ischemic stroke. Am J Obstet Gynecol. 2017;216(5):489.e1–7.

    Article  CAS  Google Scholar 

  49. Li H, Yu Y. Association between ischemic stroke and migraine in elderly Chinese: a case-control study. BMC Geriatr. 2013;13:126.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Li L, Schulz UG, Kuker W, Rothwell PM, Oxford Vascular S. Age-specific association of migraine with cryptogenic TIA and stroke: population-based study. Neurology. 2015;85(17):1444–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Rambarat CA, Elgendy IY, Johnson BD, Reis SE, Thompson DV, Sharaf BL, et al. Migraine headache and long-term cardiovascular outcomes: an extended follow-up of the women’s ischemia syndrome evaluation. Am J Med. 2017;130(6):738–43.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kurth T, Winter AC, Eliassen AH, Dushkes R, Mukamal KJ, Rimm EB, et al. Migraine and risk of cardiovascular disease in women: prospective cohort study. BMJ. 2016;353:i2610.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Schurks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009;339:b3914.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Abanoz Y, Gulen Abanoz Y, Gunduz A, Uluduz D, Ince B, Yavuz B, et al. Migraine as a risk factor for young patients with ischemic stroke: a case-control study. Neurol Sci. 2017;38(4):611–7.

    Article  PubMed  Google Scholar 

  55. Peng KP, Chen YT, Fuh JL, Tang CH, Wang SJ. Migraine and incidence of ischemic stroke: a nationwide population-based study. Cephalalgia. 2017;37(4):327–35.

    Article  PubMed  Google Scholar 

  56. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376(9735):112–23.

    Article  PubMed  Google Scholar 

  57. Johansson BB. Hypertension mechanisms causing stroke. Clin Exp Pharmacol Physiol. 1999;26(7):563–5.

    Article  CAS  PubMed  Google Scholar 

  58. Yoon SS, Carroll MD, Fryar CD. Hypertension prevalence and control among adults: United States, 2011-2014. NCHS Data Brief. 2015(220):1–8.

    Google Scholar 

  59. Ong KL, Cheung BM, Man YB, Lau CP, Lam KS. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007;49(1):69–75.

    Article  CAS  PubMed  Google Scholar 

  60. 2016. Available from: https://www.cdc.gov/nchs/data/hus/2016/.

  61. Muntner P, Davis BR, Cushman WC, Bangalore S, Calhoun DA, Pressel SL, et al. Treatment-resistant hypertension and the incidence of cardiovascular disease and end-stage renal disease: results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Hypertension. 2014;64(5):1012–21.

    Article  CAS  PubMed  Google Scholar 

  62. Wenger NK, Ferdinand KC, Bairey Merz CN, Walsh MN, Gulati M, Pepine CJ. Women, hypertension, and the systolic blood pressure intervention trial. Am J Med. 2016;129(10):1030–6.

    Article  PubMed  Google Scholar 

  63. Appelman Y, van Rijn BB, Ten Haaf ME, Boersma E, Peters SA. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015;241(1):211–8.

    Article  CAS  PubMed  Google Scholar 

  64. Peters SA, Huxley RR, Woodward M. Comparison of the sex-specific associations between systolic blood pressure and the risk of cardiovascular disease: a systematic review and meta-analysis of 124 cohort studies, including 1.2 million individuals. Stroke. 2013;44(9):2394–401.

    Article  PubMed  Google Scholar 

  65. Wolf P, Abbott R, Kannel W. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983–8.

    Article  CAS  PubMed  Google Scholar 

  66. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation: a major contributor to stroke in the elderly. The Framingham Study. Arch Intern Med. 1987;147(9):1561–4.

    Article  CAS  PubMed  Google Scholar 

  67. McGrath ER, Kapral MK, Fang J, Eikelboom JW, O’Conghaile A, Canavan M, et al. Association of atrial fibrillation with mortality and disability after ischemic stroke. Neurology. 2013;81(9):825–32.

    Article  PubMed  Google Scholar 

  68. Ko D, Rahman F, Schnabel RB, Yin X, Benjamin EJ, Christophersen IE. Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis. Nat Rev Cardiol. 2016;13(6):321–32.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Arch Intern Med. 1995;155(5):469–73.

    Article  CAS  PubMed  Google Scholar 

  70. Shroff GR, Solid CA, Herzog CA. Atrial fibrillation, stroke, and anticoagulation in Medicare beneficiaries: trends by age, sex, and race, 1992-2010. J Am Heart Assoc. 2014;3(3):e000756.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Emdin CA, Wong CX, Hsiao AJ, Altman DG, Peters SA, Woodward M, et al. Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies. BMJ. 2016;532:h7013.

    Article  CAS  PubMed  Google Scholar 

  72. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137(2):263–72.

    Article  PubMed  Google Scholar 

  73. Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864–70.

    Article  CAS  PubMed  Google Scholar 

  74. Wagstaff AJ, Overvad TF, Lip GY, Lane DA. Is female sex a risk factor for stroke and thromboembolism in patients with atrial fibrillation? A systematic review and meta-analysis. QJM. 2014;107(12):955–67.

    Article  CAS  PubMed  Google Scholar 

  75. Hong Y, Yang X, Zhao W, Zhang X, Zhao J, Yang Y, et al. Sex differences in outcomes among stroke survivors with non-valvular atrial fibrillation in China. Front Neurol. 2017;8:166.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Phan HT, Blizzard CL, Reeves MJ, Thrift AG, Cadilhac D, Sturm J, et al. Sex differences in long-term mortality after stroke in the INSTRUCT (INternational STRoke oUtComes sTudy): a meta-analysis of individual participant data. Circ Cardiovasc Qual Outcomes. 2017;10(2):e003436. https://doi.org/10.1161/CIRCOUTCOMES.116.003436.

  77. Thompson LE, Maddox TM, Lei L, Grunwald GK, Bradley SM, Peterson PN, et al. Sex differences in the use of oral anticoagulants for atrial fibrillation: a report from the National Cardiovascular Data Registry (NCDR(R)) PINNACLE Registry. J Am Heart Assoc. 2017;6(7):e005801. https://doi.org/10.1161/JAHA.117.005801.

  78. Humphries KH, Kerr CR, Connolly SJ, Klein G, Boone JA, Green M, et al. New-onset atrial fibrillation: sex differences in presentation, treatment, and outcome. Circulation. 2001;103(19):2365–70.

    Article  CAS  PubMed  Google Scholar 

  79. Singer DE, Chang Y, Fang MC, Borowsky LH, Pomernacki NK, Udaltsova N, et al. The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Ann Intern Med. 2009;151(5):297–305.

    Article  PubMed  PubMed Central  Google Scholar 

  80. McGrath ER, Kapral MK, Fang J, Eikelboom JW, Conghaile AO, Canavan M, et al. Antithrombotic therapy after acute ischemic stroke in patients with atrial fibrillation. Stroke. 2014;45(12):3637–42.

    Article  CAS  PubMed  Google Scholar 

  81. Avgil Tsadok M, Jackevicius CA, Rahme E, Humphries KH, Pilote L. Sex differences in dabigatran use, safety, and effectiveness in a population-based cohort of patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes. 2015;8(6):593–9.

    Article  PubMed  Google Scholar 

  82. Emerging Risk Factors C, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22.

    Article  CAS  Google Scholar 

  83. Iso H, Rexrode K, Hennekens CH, Manson JE. Application of computer tomography-oriented criteria for stroke subtype classification in a prospective study. Ann Epidemiol. 2000;10(2):81–7.

    Article  CAS  PubMed  Google Scholar 

  84. Ohira T, Shahar E, Chambless LE, Rosamond WD, Mosley TH Jr, Folsom AR. Risk factors for ischemic stroke subtypes: the Atherosclerosis Risk in Communities study. Stroke. 2006;37(10):2493–8.

    Article  CAS  PubMed  Google Scholar 

  85. Madsen TE, Khoury JC, Alwell KA, Moomaw CJ, Demel SL, Flaherty ML, et al. Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study. J Diabetes. 2017;10:496–501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Peters SA, Huxley RR, Woodward M. Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775 385 individuals and 12 539 strokes. Lancet. 2014;383:1973–80.

    Article  PubMed  Google Scholar 

  87. Stevens RJ, Coleman RL, Adler AI, Stratton IM, Matthews DR, Holman RR. Risk factors for myocardial infarction case fatality and stroke case fatality in type 2 diabetes: UKPDS 66. Diabetes Care. 2004;27(1):201–7.

    Article  PubMed  Google Scholar 

  88. Ho JE, Paultre F, Mosca L. Is diabetes mellitus a cardiovascular disease risk equivalent for fatal stroke in women? Data from the women’s pooling project. Stroke. 2003;34(12):2812–6.

    Article  PubMed  Google Scholar 

  89. Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA. 2011;306(11):1241–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Pan A, Okereke OI, Sun Q, Logroscino G, Manson JE, Willett WC, et al. Depression and incident stroke in women. Stroke. 2011;42(10):2770–5.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Wassertheil-Smoller S, Shumaker S, Ockene J, Talavera GA, Greenland P, Cochrane B, et al. Depression and cardiovascular sequelae in postmenopausal women. The Women’s Health Initiative (WHI). Arch Intern Med. 2004;164(3):289–98.

    Article  PubMed  Google Scholar 

  92. Smoller JW, Allison M, Cochrane BB, Curb JD, Perlis RH, Robinson JG, et al. Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Women’s Health Initiative study. Arch Intern Med. 2009;169(22):2128–39.

    Article  PubMed  Google Scholar 

  93. Mackay J, Mensah G. The atlas of heart disease and stroke. Geneva: World Health Organization; 2004.

    Google Scholar 

  94. House A, Dennis M, Mogridge L, Hawton K, Warlow C. Life events and difficulties preceding stroke. J Neurol Neurosurg Psychiatry. 1990;53(12):1024–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Rich-Edwards JW, Mason S, Rexrode K, Spiegelman D, Hibert E, Kawachi I, et al. Physical and sexual abuse in childhood as predictors of early-onset cardiovascular events in women. Circulation. 2012;126(8):920–7.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Emer R. McGrath .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McGrath, E.R., Rexrode, K.M. (2019). Stroke Risk Factors in Women. In: O’Neal, M. (eds) Neurology and Psychiatry of Women. Springer, Cham. https://doi.org/10.1007/978-3-030-04245-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-04245-5_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04244-8

  • Online ISBN: 978-3-030-04245-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics