The occurrence of stroke in men is less common than in women -- it's the fifth leading cause of death for men versus the third leading cause for women, according to the National Stroke Association. But that statistic is somewhat skewed by the fact that individuals are at a higher risk for stroke at older ages, said Mani K. Nezhad, MD, Vascular and General Neurology with Dignity Health Medical Group in the Ventura, California, region. Because women tend to live longer than men, their average likelihood for stroke is higher by default. However, stroke incidence tends to be more frequent for men at younger ages. It's critical to learn about stroke in men, risk factors, and how to prevent or minimize those risks.
What a Stroke Looks and Feels Like
Individuals can suffer from two subsets of stroke: ischemic or hemorrhagic. Both can outwardly "present," or appear, in the same way because it depends on which part of a person's brain is being affected, Dr. Nezhad said.
Ischemic strokes, comprising 87 percent of all strokes, occur because of blockage in a blood vessel that leads to the brain, according to the American Heart Association. When blood doesn't get to part of the brain, it can be damaged or die off, depending on how long it's deprived of blood and oxygen. Hemorrhagic strokes happen for various reasons, including vascular malformation, an abnormal growth of brain blood vessels, or a ruptured aneurysm, when a clotted blood vessel inside the brain ruptures and leaks blood into spaces around the brain.
All strokes tend to occur with an acute onset and few immediate warning signs. Anterior and posterior circulation strokes can manifest with different symptoms, but the most common stroke symptoms tend to be similar:
During a posterior circulation stroke, Dr. Nezhad recommends watching for the three Ds: diplopia (double vision), dysarthria (slurring of speech), and dysphasia (difficulty swallowing).
Treatments and Recovery
Strokes can be frightening for the person affected or loved ones witnessing it. If you notice someone suddenly suffering from these symptoms, the most important factor in their recovery is time. "We have very good therapies, but they're very time-dependent because the brain is sensitive in the amount of time that it cannot have oxygen," said Dr. Nezhad. "We say in stroke neurology, 'Time is brain,' which means the sooner you act, the more brain you save."
At the stroke center, doctors may prescribe intravenous medications, called IV tPA. For patients with larger strokes, the doctor may use a catheter to remove the clot from the brain. Doctors may also recommend a blood thinner, especially if the patient has a heart arrhythmia.
Stroke recovery can vary, but patients make the most progress in the first three to six months following a stroke, with recovery plateauing around two years. "That's why it's important after you have the stroke to maximize physical, occupational, or speech therapy," said Dr. Nezhad. "Because the more you do earlier on, the more motivated you are to recover from your stroke, the more likely you are to be independent from your stroke."
While the stroke may not have warning signs, men can identify certain risk factors -- particularly vascular-related factors -- that could raise their likelihood of having a stroke. Here are a few to keep in mind:
- Age (50+)+
- Hypertension (high blood pressure)
- High blood sugar/diabetes
- Heart arrhythmia/atrial fibrillation
- Transient ischemic attack (TIA): Stroke symptoms that last less than 24 hours
- Carotid artery stenosis: Narrowing of the blood vessels to the brain
- Vascular dissections: Tears in the blood vessels to the brain, often caused by contact sports or hard workouts
- Hormone replacements: Testosterone has been reported to increase the risk of blood clots
To reduce stroke risk, Dr. Nezhad recommends controlling vascular-related risk factors, such as high blood pressure, high cholesterol, or high blood sugar. Aside from prescribed medications, he also suggests stroke sufferers adjust their diet to focus mostly on a Mediterranean diet that's rich in vegetables, legumes, whole grains, and fish.
During annual physicals, doctors will also listen to the arteries in the patient's neck to detect the presence of carotid bruit, or turbulence in the carotid arteries. If it exists, the patient may be a candidate for surgery, which can reduce the risk of stroke.
Stroke in men may be a less common occurrence, but men should still manage their vascular-related risk factors for stroke as they age. This will help you work toward a long, healthy, and independent life.