A Surge in Strokes

But even women whose weight is within the normal range, like Puopolo, can be at increased risk. In the last few years Puopolo, a former smoker, had developed high blood pressure and started taking medication to control it. But side effects prompted her to stop, and she let months go by without making an appointment to get a different medicine. "I wasn't really aware how dangerous high blood pressure was," says Puopolo.

Towfighi says recent data seem to indicate that women's blood pressure is increasing at a faster rate—8 to 10 points a decade, starting at age 35—than men's, which is increasing by 4 or 5 points per decade. Taking medication helps reduce the risk, but it doesn't eliminate it. "Before most people started on their medication, damage was done to their blood vessels, and that increases their risk of stroke," says Towfighi.

High cholesterol, another risk factor, is also becoming a bigger problem for women. Studies indicate that before age 44 men's cholesterol tends to be higher than women's. But after age 44 women's total cholesterol begins to rise faster than men's, and by the time women are between 55 and 64 they typically have higher cholesterol levels than men.

Not surprisingly, having multiple risk factors (including smoking and using birth control pills or hormone therapy) increases the chance of stroke. So does having the constellation of conditions known as metabolic syndrome, which not only exponentially increases the overall risk of stroke but increases the risk of stroke more for women than for men, says Towfighi. Those with metabolic syndrome suffer from high blood pressure, insulin resistance, increased fat around the waist and abnormal cholesterol levels (specifically, elevated levels of triglycerides and reduced levels of high-density lipoprotein, known as HDL, or the good fats).

The lesson to be learned from this latest round of stroke research, says Towfighi, is that women should really make a point of eating a healthy diet. That means avoiding saturated fat and foods high in cholesterol, eating five servings a day of fruits and vegetables, and exercising at least a half an hour a day. Women should also know what their blood pressure is, and what normal is. The same is true of cholesterol. "We need to start curbing our risk factors early on," says Towfighi.

It's also crucial that women learn the warning signs of a stroke and know what to do if one occurs. The American Stroke Association says that if someone has any of these "five suddens" she should be rushed to the hospital to determine if she has had some type of stroke: