Perimenopausal women, especially those who are African American or Hispanic, should be targeted for primary stroke prevention, according to researchers.
SAN ANTONIO—Menopausal status and ethnicity can influence the incidence of modifiable stroke risk factors in women, according to findings presented at the 2010 International Stroke Conference. A high incidence of stroke risk factors among women with premature menopause indicates that the age of menopause onset is not significant, reported Carolyn Strimike, MSN, RN, APRN, and Margaret Latrella, MSN, RN, APRN, of the Women’s Heart Center at St. Joseph’s in Paterson/Wayne, New Jersey.
“Ideally, health care providers should evaluate for stroke risk factors when women are premenopausal and closely monitor the women as they progress through menopause,” said the study authors. “Early risk factor identification and patient education can empower women to take control and reduce their risk for stroke.”
The researchers examined 2,259 women for the presence of modifiable stroke risk factors, including blood pressure, cholesterol and triglyceride levels, weight, waist circumference, and diabetes status, during a comprehensive stroke/cardiovascular examination. The women were categorized according to their ethnicity and menopausal status, and whether they had dyslipidemia, hypertension, and/or metabolic syndrome.
About 60% of participants were postmenopausal—57% Caucasian, 25% African American, and 14% Hispanic. Approximately 30% of the women were premenopausal—34% Caucasian, 22% African American, and 38% Hispanic. In addition, 9% of participants were perimenopausal.
“Significant increases in the incidence of hypertension and cholesterol disorders occurred in all ethnic groups, while African Americans and Hispanics also had significantly higher incidences of metabolic syndrome, high triglycerides, and diabetes,” stated the study authors. “Stroke risk scores were consistently higher in African American women across all menopausal stages.”
In addition, African American women had a significant increase in metabolic syndrome and diabetes between premenopause and perimenopause, according to the investigators. “Hispanic women had a significant increase in metabolic syndrome and diabetes between perimenopause and postmenopause,” they reported. “White women had a significant increase in metabolic syndrome between perimenopause and postmenopause.”
The researchers also found that African American and Hispanic women had a significant increase in dyslipidemia between premenopause and perimenopause, while Caucasian women had a significant increase in dyslipidemia between perimenopause and postmenopause. Furthermore, African American and Hispanic women had a significant increase in triglycerides between premenopause and postmenopause.
“Although weight gain and increase in waist circumference were evident through menopausal transition, they were not statistically significant,” the investigators reported.
Three percent of women experienced premature menopause, and rates of modifiable risk factors were high in this group—45% had hypertension and/or metabolic syndrome, 42% had cholesterol disorders, and 92% were overweight.
“Screenings for stroke risk factors should be performed in premenopausal women, especially in African American and Hispanic women,” concluded Ms. Strimike and Ms. Latrella. “While stroke mortality rates in men have decreased, women have not experienced the same trend, making prevention even more critical.”
—Colby Stong
Suggested Reading
Towfighi A, Saver JL, Engelhardt R, Ovbiagele B. A midlife stroke surge among women in the United States. Neurology. 2007;69(20):1898-1904.