There are now 45 per cent more females than males dying from stroke in Canada every year, according to the latest numbers from the Heart and Stroke Foundation.

At all ages, a man has a higher risk of having a stroke than a woman. But each year, more women than men die from stroke -- and the gap is widening.

In 1973, there were 8,523 female deaths from stroke compared to 7,702 male deaths -- a 10 per cent difference. By 2004, female deaths increased to 8,667 while male deaths dropped to 5,959.

Data suggests that the lifetime risk for a middle-aged woman of having a stroke is one in five, but just one in 10 for a middle-aged man.

Part of the reason for the gap is the simple fact that women tend to live longer on average than men, and the chances of dying from a stroke increases with age.

"We know that our population is aging and we know that women live longer than men and stroke is a disease of elderly people, so statistically women are more likely to be experiencing strokes at older ages," Dr. Gord Gubitz of the Heart and Stroke Foundation told CTV Newsnet on Tuesday from Halifax.

The main risk factors for stroke are the same for both genders: high blood pressure, diabetes, smoking, inactivity and high cholesterol. But new research suggests there may be some risk factors that are unique to women.  These include:

  • Migraines:
    A review of the research shows that among women 20-44 years of age, those who have migraines have double the risk of stroke. More recently, a study found that women who have migraines with visual disturbances such as flashing dots or blind spots can be up to 10 times more likely to have a stroke.
  • In the 2003 Canadian Community Health Survey, 15 per cent of women age 30 and over reported migraines, compared to only six per cent of men.
  • Hormone Replacement Therapy (HRT):
    Although most women who take HRT will not have a stroke, women who take estrogen and progestin HRT for less than two years have a 40 per cent higher risk. It is important that women who take or are considering HRT talk to their doctors about the benefits and risks.
  • Oral Contraceptives:
    For most women, the risk of stroke from taking oral contraceptives (birth control pills) is very small. However, for women who smoke, have high blood pressure, migraines or blood clotting disorders, the risk is much higher.
  • Pre-eclampsia:
    Pre-eclampsia is a form of pregnancy-associated high blood pressure that occurs in about five to seven per cent of all pregnancies. Research suggests that women who develop pre-eclampsia have a 60 per cent greater risk of non-pregnancy-related ischemic stroke.

By far, the leading risk factor for stroke is high blood pressure. Over 5 million Canadians have high blood pressure, and of these, 42 per cent don't even know that they have it.

More than 21 per cent of Canadian women 45-64 years of age have high blood pressure, and nearly 48 per cent of women age 65 or older have high blood pressure.

Gubitz said high blood pressure is one risk factor the Heart and Stroke Foundation is paying close attention too.

He recommended postmenopausal women should consult a physician about HRT to help determine their individual risk factors and to help decipher conflicting literature on the treatment.

"The important consideration there is the balance between the risk and the benefit. In general, the Heart and Stroke Foundation does not advocate using hormone replacement therapy to prevent a first stroke or for preventing a second stroke," Gubitz said.

"It would be up to each woman to sit with their physician and go through the pros and cons with her individually because there are other treatments that can be used to ameliorate some of the symptoms related to the postmenopausal state."

Gubitz explained symptoms of a stroke may be experienced differently by men women but it's important to notice any sudden changes like the following:

  • Sudden onset of weakness
  • Numbness in or tingling down one side of the body
  • Sudden loss in the ability to speak well or to understand speech
  • Sudden loss or doubling of vision
  • A "thunder clap" type of headache characterized by extreme and sudden pain that could "drop you to your knees."

The good news is that Canadian researchers are finding women are not only benefiting as much as men from new stroke treatments, they may even be doing better.

"Over the past decade there have been dramatic advances in therapies to decrease death and disability from stroke," agreed Dr. Moira Kapral. "But some studies suggest that some effective treatments are under-used in women, and we need to do further research to find out why."

The Heart and Stroke Foundation estimates there are between 40,000 to 50,000 strokes in Canada each year, and 300,000 Canadians living with the effects of stroke.

According to the Heart and Stroke Foundation, of every 100 people who have a stroke, approximately 15 will die, 10 will recover completely, 25 will recover with a minor impairment or disability, 40 will be left with a moderate to severe impairment and 10 will be so severely disabled that they require long-term care.