Calgary doctor calls for more research as new study shows women more likely to die of stroke than men

Heart and Stroke Foundation report reveals major differences in medical outcomes

Image | shelagh coutts stroke

Caption: Dr. Shelagh Coutts, a stroke neurologist and associate professor at the Cumming School of Medicine, would like to see more education targeted at women and more female patients involved in research. (Riley Brandt, University of Calgary)

A Calgary neurologist says strokes take a big toll on her female patients and their families, and she'd like to see improved research on women and stroke and greater awareness of the potentially deadly health condition.
A new report by the Heart and Stroke Foundation(external link) shows that strokes, which happen when blood stops flowing to part of the brain, are taking a higher toll on Canadian women than men.
According to the report, one-third more women die of stroke than men in Canada. Of the 62,000 strokes that occur in Canada every year, more than 30,200 happen to women.
"We definitely see more women with bigger strokes who are struggling," said Dr. Shelagh Coutts, a Calgary-based stroke neurologist and associate professor of neurology at the University of Calgary.

Image | Lori Beaver stroke study

Caption: Lori Beaver had a stroke in 2003 when she was in her forties. She started a peer-support program at Foothills hospital in 2009 and found many women were not aware of the risk of stroke. (Jennifer Lee/CBC)

'I had no idea'

Calgarian Lori Beaver is one of 214,000 Canadian women living with the effects of stroke.
In 2003, when Beaver was in her 40s, she woke up with numbness in her right arm. When that progressed into problems with her right leg, she was rushed to the hospital.
"I had no idea that a person of my age and physical wellness would have a stroke," said Beaver, who spent nearly four months in the Foothills hospital recovering.
She's not alone. According to the Heart and Stroke Foundation, women are not sufficiently aware of their stroke risks or of the signs of stroke. In a poll, commissioned by the group, 36 per cent of women did not know any of the signs.

Image | FAST signs of stroke

Caption: Quick treatment can improve stroke outcomes, which is why it's important to know the most common signs of stroke: facial drooping, inability to raise one or both arms, and slurred or jumbled speech. If any of these symptoms are present, call 911. (Heart and Stroke Foundation of Canada)

"I think there is a perception out there ... that men have strokes and men have heart attacks. And that's not true. Women obviously have both heart attacks and strokes, and the impact is very significant on families," said Coutts.

Fewer women get help after stroke

The report also shows that less than half of stroke survivors in rehabilitation programs are women, "putting them at a disadvantage for making the best recovery possible."
According to the Heart and Stroke Foundation, women are 60 per cent less likely to regain their independence and twice as likely to end up in long-term care than men.
Coutts, who regularly treats women who've experienced stroke, says that because women tend to outlive their spouses, they can be left with no support at home once they are released from hospital.
"If you're on your own, which often unfortunately happens to elderly women ... it's very hard because you can't get enough care in the community. And unfortunately if you survive, you'll end up in long-term care."

Image | Shelagh coutts stroke

Caption: Dr. Shelagh Coutts says women are under-represented in most stroke studies. (Riley Brandt, University of Calgary)

Women's experiences differ

Fifteen years after her stroke, Beaver still struggles with the long-term impacts. When she is tired she tends to slur her words. She has some difficulty walking and her memory is also affected.
In 2009, Beaver started a peer-support program at Foothills. Volunteers who have lived through stroke, or caregivers of someone who has, visit with patients on the stroke unit.
During her visits she saw a common thread among female patients.
"Even though they were very ill, they were still worried about their families. [They would say] 'I just want to get out of here,' 'how can I make the doctor release me faster.' And so I think there's always that impetus that they're always caring for their families."

More research and support needed

Part of the problem, according to Coutts, is a gap in knowledge.
"Women have been under-represented in most of the studies done to date," she said.
"I think there needs to be much more of a targeted education of women of the symptoms of stroke.… Also clinical trials need to make sure that they have much more representation of both sexes."
For Beaver, whose life has changed as a result of her stroke, improved awareness and supports for women are key.
"It's something that doesn't go away.… More resources would help people deal with it better."