Ischemic stroke rates in women of reproductive age increased by 59% from 2012 to 2022, while intracerebral hemorrhage rates tripled during the same period.
The incidence of ischemic and hemorrhagic strokes in women of reproductive age significantly increased between 2012 and 2022, highlighting a growing cardiovascular risk in this demographic.
Background: Previous work has established that women under 65 are at higher risk of stroke than men of the same age. The objective of the current study was to examine time trends in ischemic and hemorrhagic stroke in women of reproductive age from 2012-2022. Methods: We utilized the National Inpatient Sample, a large, nationally representative, all-payer hospital discharge database to identify rates of ischemic and hemorrhagic strokes in adult women of reproductive age (18-44 years). Rates of ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) were calculated as cases per 100,000 discharges. Select risk factors associated with stroke were also evaluated. Logistic regression was utilized to examine differences in rates over time. All analyses were completed in SAS 9.4. Results: Rates of IS increased over time (545.5 in 2012 vs 859.2 in 2022, OR=1.59, 95% CI 1.47-1.71), with Black women having the highest rates overall (770.8 in 2012 vs 1091.2 in 2012, Figure 1). ICH rates tripled between 2012 and 2022 (OR=3.23, 95% CI 2.80-3.73), a trend that was similar across all racial groups (Figure 2). SAH rates showed a modest increase between 2012 (rate=120.9) and 2022 (rate=171.3, OR=1.47, 95% CI 1.25-1.72, Figure 3). No racial disparities were observed in hemorrhagic stroke incidence. In 2022, the odds of hypertension (OR=1.25, 95% CI 1.24-1.26) and diabetes (OR=1.26, 95% CI 1.25-1.28) were 25% higher than in 2012. Hypercholesterolemia rates were stable over time, with the lowest at 1.2% in 2017 and highest at 1.6% in 2012. Conclusions: Odds of ischemic and hemorrhagic stroke in women of reproductive age has increased over time, with ICH rates increasing by over 300% between 2012 and 2022. Odds of IS increased by 59%, and SAH by 47% during the study period, while risk factors associated with stroke showed more modest increases over time. Future research will evaluate other potential factors associated with this increasing trend of stroke in younger women.
Christopher et al. (2026) studied this question. Ischemic stroke rates in women of reproductive age increased by 59% from 2012 to 2022, while intracerebral hemorrhage rates tripled during the same period.