Canadian women are one-third more likely to die of stroke than men, in large part because they are woefully uninformed about the warning signs of stroke and slow to get treatment.
That is the conclusion of a new study from the Heart and Stroke Foundation of Canada.
A survey commissioned by the foundation shows that one in three women cannot identify even two of the warning signs of stroke - sudden numbness, difficulty speaking, blurry vision, severe headache and dizziness.
And they are no better at identifying the underlying causes, according to the poll: One in four women cannot identify even one major stroke risk factor, which include high blood pressure, smoking, diabetes and physical inactivity.
"Canadian women need to be better stroke detectors," said Frank Silver, a neurologist and medical director of the Toronto West Stroke Network.
He said the knowledge is particularly important because about 80 per cent of strokes are preventable. Additionally, Dr. Silver said, a lot of the devastating consequences of stroke - paralysis, loss of speech, blindness, memory loss - can be prevented with prompt treatment.
"A patient can go from being perfectly devastated to fine right before your eyes if they get prompt treatment," Dr. Silver said. "We call it the Lazarus effect."
That was the case for Ann Dooley, a professor of medieval and Celtic studies at the University of Toronto.
In the early morning hours of April 21, she was speaking to her husband when the words leaving her mouth became nothing but gibberish. He immediately called 9-1-1.
When the paramedics arrived, they asked Prof. Dooley to smile - but only half her mouth moved.
"They knew immediately it was a stroke," she said. "But there was no pain. I was totally serene."
At Toronto Western Hospital, Prof. Dooley was treated with tissue plasminogen activator (tPA), known colloquially as clot-busters. The drug, which dissolves clots that block blood flow to the brain, can totally reverse stroke symptoms if administered promptly.
Within a few hours, Prof. Dooley was speaking normally again and felt fine.
But, post-recovery, she was determined to educate others about the risks and warning signs of stroke. "I'm an educated woman but I had absolutely no idea. Stroke never entered my consciousness because I was healthy," Prof. Dooley said.
The principal risk factor for stroke is hypertension, a condition that increases with age.
"Getting high blood pressure under control makes a tremendous difference; it can really lower your risk of stroke," Dr. Silver said.
High blood pressure is treated principally with lifestyle modification - reducing salt intake, losing weight and increasing physical activity - and with medications like diuretics.
People with atrial fibrilation - irregular and sometimes rapid heartbeat - are also at much higher risk of stroke, but it can be prevented with anti-coagulants.
In 2007, the most recent year for which detailed statistics are available, a total of 8,262 women and 5,719 men died of stroke.
In total, 69,503 Canadians died of heart disease, including ischemic heart disease, heart attack and stroke, divided almost evenly between men and women.
André Picard