Menopause Increases Stroke Risk – Part 1

Rebecca M.

As covered in-depth by the NIH, women that are through menopause, who have a different hormonal make-up than younger women, have a higher risk of stroke, an acquired brain injury.  This is due to changes in hormones, especially those linked to estrogen, which drops significantly after menopause.  Stroke was once thought to be primarily a male disease, but the number of women that are having strokes has been increasing.  Although men still have a greater risk of stroke overall, the risk of stroke for women between the ages of 50 and 60 (the median menopause age is 51) is greater than that of men at that age.  This is true for women of all races.  (As stress also contributes to stroke rates, I wonder if women with stressful jobs that have been through menopause might be at an even higher risk, as there is evidence that higher stress is contributing to more strokes in younger people.

Currently, legislation does not appear to address strokes or heart disease in any way, but it is addressed by the executive branch of the federal government.  Sometime between the years 2003 and 2005, statistical data was ordered by George W. Bush’s first Secretary of Health and Human Services Tommy Thompson.  The following report called for strengthening the nation’s public health capacity at the state and federal levels. The plan, though created nationally, required community level action to catch risk factors for stroke and heart disease and make changes accordingly, especially those changes that could be implemented through environmental change.  (Environmental change is what a federal agency or legislation would be able to focus on, not on biologically predetermined risks.)  There was also a call for more research in all areas, including the genetic area, so that individuals could be properly tracked and helped before they suffered any risks.   At the time of the report, heart disease and stroke required 3% of the U.S. budget to address and that number was expected to rise as more “baby boomers” reached old age.

It is a bit surprising that there has not been a follow-up on statistics since 2010.  The surprise is not so much based on inaction in the Trump Presidency, which has been less than a year and a half, but during the Obama Presidency, when healthcare was such a signature issue, especially in his first term. There was no continuity from the Bush years.

Though this report focuses on heart disease, as well as on stroke, it is noted early on that the public health burden from stroke has grown at a faster rate, possibly because disability resulting from stroke requires long-term care.  The goal of the report was to strengthen programs that allow for early detection of the two types of disease and thus ensure strong and economically-sound responses to the epidemics.  The hope was that better models for detection and for treatment could be developed nationally and by the international CDC that would be used at the community level. I did not, however, find more up-to-date reports like this, which was issued roughly 14 years ago.  At the time of the report, heart disease was the #1 cause of death in all people in the U.S. over 65, and stroke was the #1 cause of disability.

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