Provided by UVA Health
What Every Woman Needs to Know to Protect Her Brain
Stroke can be devastating for anyone—but when it comes to risk, symptoms, and recovery, women face a different reality than men. From pregnancy-related risks to subtle warning signs that are easier to dismiss, stroke in women is often underrecognized and undertreated, according to the American Heart Association.
Why High Blood Pressure Matters More for Women
“High blood pressure is the single biggest risk factor for stroke in both women and men. But for women, the danger appears to start earlier. For a given level of high blood pressure, the risk of stroke may be higher for women,” says Skarlet Patino-Velasquez, MD, cardiologist, UVA Health Prince William Medical Center.
Current guidelines define high blood pressure as 130/80 or higher. But research shows that women with “elevated” blood pressure (120–129 systolic) can face the same stroke risk as men whose readings are much higher.
“The takeaway? If you’re a woman, even borderline-high blood pressure deserves serious attention,” added Patino-Velasquez.
Pregnancy: A Window into Lifelong Stroke Risk
Pregnancy is often described as a stress test for the heart—and for good reason. Blood volume and cardiac output increase by nearly 45%.
Complications such as preeclampsia, gestational diabetes, and premature labor don’t just affect pregnancy outcomes; they can raise a woman’s risk of stroke for the rest of her life.
As many as 1 in 5 women experience adverse pregnancy outcomes, which are linked to both ischemic and hemorrhagic strokes later in life. Early menopause, especially before age 45, is another women-specific risk factor.
And stroke isn’t just a concern for older women. Studies show that stroke risk in women ages 25 to 44 is at least as high as in men the same age.
When Stroke Symptoms Don’t Follow the Rules
Most people know FAST:
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 911
But women are more likely to experience additional, less-recognized symptoms, such as:
- Nausea or vomiting
- Sudden confusion
- Loss of consciousness
That’s why experts emphasize BE FAST, which adds two critical warning signs.
BE FAST
- Balance loss
- Eye (vision) changes
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 911
Women are also more likely to have migraines—especially migraines with aura—which can double the risk of clot-related stroke and sometimes mimic stroke symptoms, leading to dangerous delays in diagnosis.
Stroke Risk Isn’t Equal for All Women
Disparities remain stark. Black women are twice as likely to have a stroke as non-Hispanic white women and experience higher rates of pregnancy-related high blood pressure complications.
Experts point to differences in access to health care, chronic stress, and other social factors that directly impact stroke risk and outcomes.
How Women Can Lower Their Risk
The most effective prevention strategy follows the American Heart Association’s Life’s Essential 8:
- Don’t smoke
- Maintain a healthy weight
- Stay physically active
- Eat a heart-healthy diet
- Get enough sleep
- Manage blood pressure, cholesterol, and blood sugar
Patino-Velasquez adds, “Women should know their blood pressure, talk openly with their doctors about pregnancy history, and never ignore warning signs, no matter their age. There are safe medications available during pregnancy. Women should also be aware that the risk does not end with the birth.”
The Bottom Line
Stroke research hasn’t always told the full story for women. As researchers work to better understand those differences, one thing is already clear—women’s awareness and advocacy for heart and brain health can be lifesaving.
Know your numbers. Know the signs. And remember—BE FAST. It could save your life.
