- Ischemic strokes — which occur when a blood clot blocks an artery leading to the brain — account for
87 percentof all strokes.
- A new analysis finds that women under 35 years old tend to be more likely to have this stroke compared to men.
- Additionally, women who survive ischemic strokes tend to experience difficult outcomes more often than men who survive strokes.
A large analysis reviewing 16 international studies on strokes found that young women under 35 years old are 44 times more likely to have an ischemic stroke than men.
And women who survive ischemic strokes tend to experience difficult outcomes more often than men who survive strokes.
Ischemic strokes — which occur when a blood clot blocks an artery leading to the brain — account for
Why that occurs is still unclear, but cardiologists suspect oral contraceptives, pregnancy, and childbirth may impact young women’s chance of stroke.
Dr. Hoang Nguyen, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, says he has seen an increase in young people presenting with heart attacks and stroke — more and more of whom are women.
Women often have atypical presentation of heart attacks, and the same may be true for stroke, according to Nguyen.
“This article really touches on something many clinicians have known in their gut and from clinical experience. More research is needed to broaden our understanding of ischemic stroke in younger women to improve clinical outcomes,” Nguyen told Healthline.
Symptoms of a stroke in women can include the following:
The researchers evaluated 16 studies conducted between 2008 and 2021 and looked at how common strokes were in men and women across various age groups.
The analysis included a combined total of 69,793 young adults — 33,775 women and 36,018 men.
The researchers found that the sex differences in stroke were most pronounced in younger adults under 35 years old.
Young women were 44 times more likely to experience an ischemic stroke than men.
Additionally, women who survived ischemic stroke faced a 2 to 3 times higher chance of difficult functional outcomes compared to men who survived ischemic stroke.
According to the authors, more research is needed to better understand how factors like pregnancy, postpartum and hormonal contraceptives contribute to young women’s overall chance of stroke.
“While the incidence of stroke in young patients is still much lower compared to older patients, this new data suggests that young women may be at higher risk of stroke compared to men of a similar age,” Dr. Hardik Amin, a Yale Medicine neurologist and stroke specialist and the medical stroke director at Yale New Haven Hospital’s St. Raphael Campus.
“We know that pregnancy and oral contraceptives can increase the risk of blood clots and lead to strokes, but there also appear to be other nontraditional risk factors in this population that require further study,” Amin said.
Nguyen says it’s possible that young women may have a higher chance of stroke due to the use of oral contraceptives.
“Oral contraceptives tend to cause blood clots in the veins, which can travel up to the right side of the heart,” Nguyen said.
If there is abnormal communication between the right and left side of the heart, complications can occur.
Pregnancy may be another contributing factor to women’s chance of stroke.
Nguyen says preeclampsia — which can cause severe hypertension during pregnancy — can lead to stroke.
Pregnancy also causes major changes to the immune system.
“This significant shift in proinflammatory and anti-inflammatory mediators can potentially put younger women at increased risk for strokes,” Nguyen said.
Dr. Amit Mahajan, chief of neuro CT/MR (CAT scan and MRI) and head and neck imaging at Yale Medicine (section of neuroradiology), says ischemic stroke needs to be studied better, as many believe that atherosclerotic disease causes most strokes.
Racial and genetic factors along with congenital anomalies may also be contributing to certain people’s chance of stroke. But it’s also important to note that the stress of enduring racism and racist systems may play a part in developing the disease beyond genetic factors.
“A very high incidence of ischemic stroke is cryptogenic — which means the cause is not known. That just means we have to work harder to find a cause for these,” Mahajan said.
The analysis found that women who survive strokes tend to experience
Nguyen suspects there may be a diagnostic bias, as doctors are traditionally advised that men, especially older men, have a higher chance of stroke than women.
This could potentially lead to delayed diagnosis and treatment in younger women, said Nguyen.
“If the diagnosis and treatment are delayed, then it would explain the worse outcomes,” Nguyen said.
A large analysis found that young women under 35 years old have a higher chance of ischemic stroke than young men, and female stroke survivors tend to face difficult health outcomes more often than their male counterparts.
It’s unclear why ischemic stroke occurs more in young women than young men, but cardiologists suspect it may be linked to pregnancy and the use of oral contraceptives. More research is needed to understand that risk factors for ischemic stroke and improve how quickly young women are diagnosed and treated.