Knowledge of stroke warning signs remains low among U.S. women

Knowledge of stroke warning signs remains low among U.S. women, particularly among racial and ethnic minorities, according to a national survey reported in a special disparities themed issue of Circulation: Journal of the American Heart Association.

Each year about 700,000 Americans have a new or recurrent stroke and nearly 40,000 more women than men die of a stroke, according to American Heart Association/American Stroke Association statistics. "Yet only one-third of women surveyed in 2003 said that they felt very well or well informed about stroke," said Anjanette Ferris, M.D., lead author of the report and a clinical fellow in cardiovascular disease at Columbia University Medical Center in New York City.

African-American women are 1.5 times more likely to have a stroke and 1.3 times more likely to die of a stroke than white women. "Our study documents a knowledge gap between racial/ethnic minorities and whites regarding stroke warning signs," Ferris said. "It is paradoxical that racial and ethnic minorities at highest risk were least aware. As with heart attack, it is critical that women at risk for stroke know the warning signs because delayed treatment can lead to greater disability or death."

The American Heart Association-sponsored telephone survey included 1,024 women ages 25 and older. Among participants, 68 percent were white, 12 percent African American and 12 percent Hispanic. The remaining 8 percent were of other ethnicities.

The survey was the third conducted since 1997 to assess trends in awareness and knowledge of heart disease and stroke, the nation's first and third leading causes of death. Questions covered knowledge of stroke warning signs, risk, prevention and treatment, among other topics. Results include:

Awareness

• Nearly one third of Hispanic women reported that they were not informed about stroke compared to 20 percent of African-American and 10 percent of white women.
• 61 percent of Hispanic women compared to 74 percent of African-American and 82 percent of white women reported that they had heard or read information about cardiovascular disease within the past 12 months.

Stroke warning signs

• More white women correctly identified stroke warning signs than did African-American or Hispanic women.
• 39 percent of white women, 32 percent of African-American women and 29 percent of Hispanic women identified sudden weakness or numbness of the face or limb on one side of the body as a warning sign.

"A significantly higher percentage of African-American respondents correctly believed that African-American women are more likely to die of a stroke than white women," Ferris said. "However, African-American women were still less likely to correctly identify stroke warning signs."

Treatment

• More white women (92 percent) knew treatment exists that can break up blood clots and reverse the course of an ischemic stroke if patients arrive at a hospital soon after the onset of symptoms. Comparable figures were 84 percent for African-American and 79 percent for Hispanic women.

"These data support the need for targeted educational programs on the warning signs of stroke and underscore the importance of public health programs to improve awareness and prevention of stroke among women, especially among minority women who are at highest risk," Ferris said.

Co-authors are Rose Marie Robertson, M.D.; Rosalind Fabunmi, Ph.D.; and Lori Mosca, M.D., Ph.D., M.P.H.