ESOC 2021: Non-traditional risk factors for heart attack and stroke rising more steeply in women


stroke risk factorsWork stress, sleep disorders, and fatigue—which are regarded as non-traditional risk factors for heart attack and stroke—are rising more steeply among women than men, according to a new study presented at the 7th European Stroke Organisation Conference (ESOC 2021; 1–3 September, virtual).

Researchers compared data from 22,000 men and women in the Swiss Health Survey from 2007, 2012, and 2017, and found an “alarming” rise in the number of women reporting these non-traditional risk factors for cardiovascular disease. The trend coincided with an increase in the number of women working full-time from 38% in 2007 to 44% in 2017.

Overall, in both sexes, the number reporting stress at work rose from 59% in 2012 to 66% in 2017, and those reporting feeling tired and fatigued increased from 23% to 29% (to 33% in women and 26% in men). The number reporting sleep disorders went up from 24% to 29%, with severe sleep disorders rising more sharply in women (8%) than in men (5%) too.

However, the research also found the traditional risk factors for developing cardiovascular disease had remained stable in the same time period, with 27% suffering from hypertension, 18% having raised cholesterol and 5% having diabetes. Obesity increased to 11% and smoking decreased by approximately one cigarette per day—from 10.5 to 9.5—but both were more prevalent in men.

Study authors Martin Hänsel, neurologist at the University Hospital Zürich in Zürich, Switzerland, and Susanne Wegener, professor of Neurology at the University of Zürich in Zürich, Switzerland, commented: “Our study found men were more likely to smoke and be obese than women, but females reported a bigger increase in the non-traditional risk factors for heart attacks and strokes, such as work stress, sleep disorders, and feeling tired and fatigued.

“This increase coincides with the number of women working full time. Juggling work and domestic responsibilities or other socio-cultural aspects may be a factor, as well as specific health demands of women that may not be accounted for in our daily ‘busy’ lives.

“We found an overall increase in non-traditional risk factors in both sexes, but these were more pronounced in female participants, while most traditional cardiovascular risk factors remained stable.

“These results underscore the fact that sex differences exist for non-traditional CVD (cardiovascular disease) risk factors with an alarming trend towards a particular increase in women.”

Wegener stated that diabetes, arterial hypertension, raised cholesterol, smoking, obesity and physical inactivity are recognised modifiable risk factors for cardiovascular disease, but recently it has been noted that non-traditional risk factors such as work pressures and sleep problems can significantly add to cardiovascular risk.

“The data show that there are a wide range of risk factors for cardiovascular disease reported and these extend beyond the medical ones officially recognised to societal pressures and will help better inform prevention strategies for heart attacks and stroke,” she added.

“Traditionally, men have been perceived to be more affected by heart attacks and strokes than women, but in some countries, women have overtaken men,” added Wegener. “There is a gender gap—and further research is needed to find out why.”


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