Analysis: Ischemic Stroke Risk Higher for Women 18–35 Years Old Than Men the Same Age

Key takeaways:

• Ischemic stroke is an urgent medical problem caused when a blood vessel in the brain is blocked.
• Women ages 18-35 were 44% more likely to have an ischemic stroke than men the same age in a review of multiple international studies.
• In the 35-45 age group, it was unclear which sex had more ischemic strokes.
• More research is needed to understand women’s unique risks for stroke. Some may include pregnancy, postpartum changes and hormonal contraceptives.

Women 18 to 35 years old are 44% more likely to have an ischemic stroke than men the same age, recent research shows.

An ischemic stroke is a life-threatening emergency that occurs when a blood vessel in the brain is blocked. It may cause brain damage, long-term disability or death.

Researchers reviewed multiple international studies on sex-specific stroke data from 2008 to 2021. Their findings were published in a Go Red for Women 2022 spotlight issue of Stroke, a peer-reviewed journal of the American Stroke Association, a division of the American Heart Association.

The analysis also showed that the sex difference narrowed among adults ages 35-45, and in older age groups, it was more difficult to determine whether more men or women have ischemic strokes due to wide variability of data in the studies reviewed.

More age- and sex-specific research is needed to identify specific causes of higher stroke prevalence in young women and to learn more about stroke signs and prevention, researchers said.

Researchers said “an assertion that young women may be disproportionately at risk of ischemic stroke represents a significant departure from our current scientific understanding.” They also said the findings have important implications about the cause of ischemic strokes in young adults.

Understanding women’s stroke risk

Stroke affects more women than men annually. It’s a leading cause of death and adult disability. Nearly 9 in 10 strokes are ischemic. Another type, hemorrhagic stroke, occurs when a blood vessel in the brain bursts.

Understanding the long-term consequences of stroke is important, experts said. Previous research found that young women who survive an ischemic stroke have up to three times higher risk of poorer functional outcomes compared to male peers.

Researchers are also trying to understand the unique stroke risk factors women face. These may include pregnancy, postpartum and hormonal contraceptives. You can’t change some factors such as age, family history and race. But other factors are modifiable. These include lowering blood pressure, stopping smoking or illicit drug use, improving diet, increasing physical activity and losing weight.

Responding to stroke

Urgent treatment for stroke is critical — it can save lives and improve recovery. Warning signs of stroke can occur suddenly and include numbness or weakness of the face, arms or legs (especially on one side of the body); confusion, trouble speaking or understanding; trouble seeing in one or both eyes; trouble walking, dizziness, loss of balance or coordination; and severe headache with no apparent cause.

The acronym F.A.S.T. is an easy way to spot and respond to a stroke: Face drooping, Arm weakness, Speech difficulty and Time to call 911.