Women and Minorities Have a Higher Risk for Stroke: Here’s Why

Each year, 55,000 more women have a stroke than men. Black Americans are almost twice as likely as whites to have a stroke for the first time. Other racial and ethnic minorities in the U.S.—including Hispanics/Latinos, Asian Americans, Native Americans, and Pacific Islanders—all have a greater likelihood of suffering or dying from stroke than their Caucasian neighbors.

What’s behind these differences? Are genetics to blame? When you understand your unique risk for stroke, what can you do to avoid a life-threatening brain attack?

Women and stroke risk

Strokes kill twice as many women as breast cancer each year. But most women aren’t even aware of their risk or how to lower it.

Why are women more likely to have a stroke than their male counterparts?

  • Pregnancy can cause normal changes in the body that increase blood pressure and put stress on the heart, which can trigger stroke.
  • Taking birth control pills (in combination with other factors, such as age, smoking, high blood pressure, or diabetes) can increase a woman’s stroke risk.
  • Hormone replacement therapy used to reduce menopausal symptoms can also impact the cardiovascular system.
  • Migraines (especially those with a visible aura) can increase a woman’s stroke risk by two and a half times. Migraine sufferers in the U.S. tend to be women.
  • Stroke risk increases as you age, and women typically live longer than men.

Women are also more likely to die from a stroke than men.

“It’s very alarming that women tend to receive emergency stroke treatment in a more delayed fashion,” which greatly reduces their chances of survival, said Dr. Negar Asdaghi, a neurologist with the University of Miami Health System who specializes in the prevention and treatment of stroke. “Women are typically older and widowed when they suffer stroke, so they’re often alone when it happens. They arrive later to the hospital.

“Our comprehensive research shows that women were less likely than men to receive life-saving treatment in a rapid fashion. Although women get comparable care, they are still less likely to receive thrombolysis (medication that dissolves dangerous clots in blood vessels) and are more likely to receive this treatment in a delayed fashion.”

Stroke risk based on race, ethnicity

The statistics are staggering. Non-whites are significantly more likely to be at risk for stroke, to have one or more strokes, and to die from this condition. But the reasons why are not as cut and dry.

Doctors, researchers, and public health officials say this increased risk is caused by a combination of socio-economic and cultural differences. Minorities in the U.S. statistically earn less income and have limited access to preventive medicine and medical care. These individuals and families are less likely to successfully manage diabetes and high blood pressure, which greatly increases the risk for stroke. The same individuals are also more likely to smoke, be overweight, and not get enough exercise and sleep. Cultural factors like diets high in trans fats, salt, and cholesterol (from fried, processed, and fast foods) also raise the risk for vascular disease and stroke, especially among younger adults.

“This disease does not respect age,” said Dr. Asdaghi. “We used to think that stroke is a disease of the elderly. While the incidence of stroke increases with age, more and more we are seeing young people with stroke. The American lifestyle has increased the risk, regardless of age. When people start smoking early and not getting enough exercise, they risk developing vascular disease and stroke earlier in life.”

How to respond to a stroke

Every minute counts when someone is suffering from a stroke. Response time can affect the victim’s brain function and mean the difference between life and death.

“When warning signs present themselves, people tend to be too conservative,” Dr. Asdaghi said. “But, delaying a trip to the hospital advances brain and tissue damage and the cognitive and cardiovascular deficits stroke can cause.” Stroke care centers and doctors can act fast with a number of life-saving surgical and pharmaceutical treatments.

Rapid response of loved ones and bystanders who call 911 for help is essential to better outcomes.

That’s why it’s important to know what to look for.

The sudden onset of one or more of the following symptoms is most often what stroke looks like among men and women, regardless of race or ethnicity. These warning signs may go away quickly before returning.

  • Face drooping
  • Numbness or weakness in an arm or leg, especially on one side of the body
  • Trouble speaking or understanding, mental confusion
  • Difficulty seeing in one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Severe and sudden headache with no known cause

While female stroke victims typically experience the same warning signs as men, women are also more likely to show unusual symptoms that can be mistaken for less urgent medical problems.

Unexpected signs of stroke:

These symptoms come on suddenly and may go away quickly before returning.

  • Loss of consciousness or fainting
  • General weakness
  • Difficulty or shortness of breath
  • Unresponsiveness or disorientation
  • Sudden behavioral change
  • Agitation
  • Hallucination
  • Nausea or vomiting
  • Pain
  • Seizures
  • Hiccups

You can lower your risk for stroke, regardless of your sex, genetics, or income level: 

  • Quit smoking
  • Effectively manage blood pressure, diabetes, and cholesterol levels
  • Avoid obesity
  • Exercise regularly
  • Eat a diet lower in trans fats, salt, and cholesterol
  • Drink less alcohol
  • Reduce your stress
  • Get enough quality sleep

“Everything you do can have a measurable impact on your health,” Dr. Asdaghi says. “Your risk for stroke drops every day after the day you stop smoking. Just 30 minutes a day of cardio exercise can dramatically reduce all causes of mortality. Small steps can make big differences in health outcomes. If today’s the day, every decision you make onwards can improve your health and outcomes.”


Dana Kantrowitz is a contributing writer for UMiami Health News.