The following is an analysis of the publication:

“A midlife stroke surge among women in the United States”

Reference: Neurology. 2007 Nov 13;69(20):1894-5.

The authors of a study published in the journal Neurology in November 2007 (results of this study appeared in the local newspaper and other newspaper nationwide), analyzed the National Health and Nutrition Examination Surveys (NHANES) to compare the prevalence of stroke in women vs. men in the middle-age years (35-64 years old). The authors also compared risk factors between gender and age to identify predictors of stroke. Demographic, clinical, and lab data were included in the statistical analysis.

The results of this study showed that in this population stroke prevalence was significantly higher for women between 45 and 54 years old, compared to men of the same ages. Risk factors strongly associated with stroke in these women were increase in the waist circumference, and coronary artery disease. Higher levels of glycohemoglobin, diabetes, and migraine were other predictors associated with stroke in women. There was another interesting finding about vascular risk factors such as systolic blood pressure and total cholesterol levels. Compared to men ages 35 to 64 years, women had a significant increase in the levels of blood pressure, cholesterol and other biomarkers.

The findings of this study suggested that women are developing cardiovascular risk factors at a higher rate as compared to men leading to an increase in life-threatening conditions such as stroke. It begs the question: What is the cause of this phenomenon in women? Although this study found a strong association between abdominal obesity and stroke, the authors concluded that more research is needed, and it is important to look at other factors present exclusively in women.

If we consider the number of women using hormonal birth control over the past 4 to 5 decades, the drastic increase in stroke incidence should not be a surprise. Research has confirmed the association between the use of hormonal contraceptives and increased risk of cardiovascular problems including stroke, heart attack, high blood pressure, blood clots, and deep venous thrombosis. Other secondary effects associated with the use of hormonal birth control are weight gain, infertility, reduced libido, and increased risk of some cancers.

It would be interesting to dig deeper and conduct a study using the same data from the NHANES survey and compare the use of hormonal contraception.