The stroke patients we treat at Atlanta Hyperbaric are mostly over 65 and they seem to be about evenly divided between men and women. Although men dominate among our younger stroke patients, we do see younger women with stroke. Researchers have been looking into the reasons why young women have strokes for decades and have identified well known risk factors. Smoking and oral contraceptive use are perhaps the best known of these risk factors, although it is believed that, without other risk factors being present, the use of low-dose oral contraceptives create little risk. Family history of stroke is also important.
A study came out recently suggesting that a major risk for stroke in young women is a specific antiphospholipid
antibody. A group from the Netherlands looked at all women under 50 years of age admitted to 16 medical centers during the 1990’s who had either stroke or heart attack. They found 175 patients with ischemic stroke and 203 with heart attack. The odds ratio for ischemic stroke was 43 to 1 in women who had a specific antiphospholipid antibody called the lupus anticoagulant. The odds ratio increased to 201 to 0 in women who used oral contraceptives and 87 to 0 in those who smoked. The increased risk was seen in women only with the lupus anticoagulant and not in women with other antiphospholipid antibodies.
What does this finding of the lupus anticoagulant being a major risk factor for stroke in young women mean? The antiphospholipid syndrome is seen in conjunction with other autoimmune diseases or by itself and is characterized by serious clotting problems. Some people walk around with these antibodies, however, and seem to have no problems at all. Phospholipids are a major component of cell membranes and the presence of these antibodies puts the person at risk for blood clots in virtually any organ. This study suggests that otherwise asymptomatic women who have these antibodies may be at risk for stroke, particularly if they smoke or use oral contraceptives.