QUESTION

For a woman, what are the most important stroke risk factors?

ANSWER

The major ones are shared by both genders—high blood pressure, diabetes, high cholesterol, smoking, being overweight and lack of exercise. But women have unique risk factors, too… • Women who take birth control pills or are pregnant are at higher risk of developing blood clots that can lead to stroke. While there are many variables involved, there may be a doubling or tripling of risk. • Lower estrogen levels after menopause may also be a factor—one study found that women who experience early menopause (before age 42) had twice the stroke risk as women who experienced menopause from age 42 through 54. Semi-synthetic hormone replacement therapy that includes progestin and conjugated equine estrogens also may slightly increase stroke risk, depending on the age at which a woman starts taking it and other factors. • Women are much more likely to get migraines than men, and that can be another risk factor. In particular, people who suffer migraines with aura (visual disturbances that frequently precede a migraine) have more than twice the risk for stroke than people who don’t have this type of headache. For both men and women, eating a healthful diet that includes fruit, vegetables, whole grains, dairy and at least two servings of cold water wild-caught fatty fish (such as salmon) twice a week and getting 30 minutes of moderate exercise on most days will go a long way in helping to prevent stroke. To learn more, read Bottom Line's guide, "How to Prevent a Stroke."