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(Stroke. 2009;40:1181.)
© 2009 American Heart Association, Inc.

Go Red for Women

Perception of Risk and Knowledge of Risk Factors in Women at High Risk for Stroke

From the Department of Neurology (J.L.D., L.D.M.), The University of Connecticut Health Center, Department of Neurology, Farmington, Conn; and Hartford Hospital (L.D.M.), Stroke Center, Hartford, Conn.

Correspondence to Louise D. McCullough, MD, PhD, The University of Connecticut Health Center, Department of Neurology, 263 Farmington Avenue, Farmington, CT 06030-1840. E-mail lmccullough{at}uchc.edu

Background and Purpose— Women face a higher mortality after stroke and have different risk factors than men. Despite educational campaigns, women continue to underestimate their own risk for stroke. We present a theoretical model to understand risk perception in high-risk women.

Methods— Eight hundred five women, ages 50 to 70 years, were selected from the University of Connecticut Cardiology Center with at least one risk factor for stroke. A 5-part questionnaire addressed stroke knowledge, risk perception, risk factors, access to health care, and demographics. Two hundred fifteen women responded by mail (28% response rate) and deidentified data were entered in SPSS. Descriptive, bivariate, and multivariate techniques assessed the proposed model.

Results— The cohort was predominantly white (91.5%), higher income (33.1% of the population earned >$75 000), and well-educated (28.6% attended graduate or professional school). Only 2 of the 37 (5.4%) women with atrial fibrillation and 11 of the 71 women with heart disease (15.5%) identified their health condition as a risk factor for stroke. Predictors of risk perception included: other women’s risk (B=0.336, P<0.001), worrying about stroke (B=0.734, P<0.001), having hypertension (B=0.686, P=0.037), and having diabetes (B=0.893, P=0.004). Only 63.9% of women with atrial fibrillation (n=23) reported taking warfarin.

Conclusions— Women were often unable to identify their health condition as a risk factor for stroke. In addition, many women were not undertaking primary prevention behaviors. Risk perception was low, and high-risk women perceived their risk of stroke to be the same as their peers. Educational strategies must advocate for and target high-risk women.

Key Words: stroke knowledge • risk perception • stroke warning signs • health belief model • women and stroke