2007 Stroke Council Award and Lecture—Influence of Health Behaviors, Social Factors, and Gender on Stroke Risk and Outcome
It is estimated that 1 in 5 women and 1 in 6 men will experience a stroke over their lifetime. As a major healthcare problem, stroke is the third leading cause of death and the leading cause of serious, long-term disability in the United States today. There are currently 5.7 million stroke survivors alive, with 15% to 30% having moderate to severe functional limitations and 20% needing constant care or institutionalization. New knowledge about genetics, treatment, and rehabilitation in stroke continues to make important gains in reduction of death rates. However, prevention is still the best strategy to reduce the burden of stroke. A number of factors have been established as independent contributors to stroke, including hypertension, smoking, diabetes, and atrial fibrillation. In addition to traditional risk factors, there is an increasing interest in the role of health behaviors and social factors in stroke risk. Epidemiological studies such as the Framingham Heart Study have recently suggested that women experience stroke at an older age, are more disabled and depressed before stroke, have limited social support systems, and are at high risk for institutionalization if they do survive. Better integration of established risk factors, health behaviors, and social dimensions can augment our understanding of those at highest risk for stroke and those most vulnerable for dependency. Public awareness of and education about this interrelationship is an important key to prevention of stroke and its aftermath.