Fatal Stroke Risk Greater In Women Smokers: How Hormones And Blood Fats Could Increase Chances Of Hemorrhagic Stroke

Women smoking
Women smokers face a greater risk of suffering a fatal stroke than male smokers, by as much as 17 percent, a recent study found. Kanaka Menehune, CC BY-NC 2.0

Women smokers may face a greater risk of suffering from fatal strokes than male smokers, a recent study finds, citing differences between each gender’s hormones and level of blood fats as contributing factors to the increased risk.

More than 80 studies spanning nearly five decades comprised the University of Minnesota (UM) researchers’ meta-analysis of smoking rates related to stroke risk. While male and female smokers face similar risks of ischemic stroke – the most common form of stroke, occurring when a blood clot stops blood flow to the brain – the team found that women who smoke face a 17 percent greater risk for a specific type of stroke that is more deadly and also rarer.

Hemorrhagic strokes, also called “bleeding strokes,” occur when weakened blood vessels rupture and bleed into the surrounding brain. As the blood accumulates, it puts increasing pressure on brain tissue. Blood flow to the brain becomes impaired and the cells inside the brain lose oxygen, eventually dying. Hemorrhagic strokes account for roughly 13 percent of stroke cases, according to the American Stroke Association.

Researchers involved with the UM study looked at cases beginning January 1, 1966 all the way through January 26, 2013. Included in this range were 81 studies with 3,980,359 individuals and 42,401 strokes available for analysis. Results confirmed the hypothesis that women and men can both reduce their stroke risk by quitting smoking – by as much as 50 percent in many cases.

"Cigarette smoking is a major risk factor for stroke for both men and women, but fortunately, quitting smoking is a highly effective way to lower your stroke risk," the study's lead author Rachel Huxley, a professor in the School of Population Health at the University of Queensland in Australia, said in a journal news release. "Tobacco-control policies should be a mainstay of primary stroke prevention programs."

Huxley and her colleagues attributed a few factors to the increased risk women may face. Female smokers, for instance, have greater increases in fats, cholesterol, and triglycerides (blood lipid) than men who smoke. These differences could be caused by underlying hormonal differences, the researchers said.

Women’s risk of fatal stroke is compounded by the fact that women also have a harder time quitting smoking, Everyday Health reports. This increased difficulty could also be explained by hormonal variance.

“Studies at Yale have found that women and men smoke for different reasons,” said Carolyn Mazure, Ph.D., director of women’s health research at Yale University. “In general, women tend to smoke to reduce stress and modulate the feelings that we all have. Men smoke for the stimulation.”

Under this assumption, women experience particularly strong cravings during their menstrual cycle and experience withdrawal symptoms that are much more pronounced than in men.

“You want people to break away from those kinds of cues,” said Mazure, who added that she empathizes with women who smoke to calm themselves down, calling it a “complex but understandable story.”

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