You probably don't worry much about having a stroke, but maybe you should. Stroke, which occurs when blood flow to the brain is cut off causing death or brain damage, can change your life forever. At its worst, stroke can severely limit your ability to live an independent and active life. At best, you can resume all of your former activities, but your road to recovery may be long and arduous.

According to the American Stroke Association, stroke is the third leading cause of death for American women and claims more than twice as many lives as breast cancer. You might be even more surprised to learn that over one fourth of the women who have a stroke in a given year are actually under the age of 65.

Today, more than 2 million American women are living with the consequences of stroke. Thirty-one percent of these stroke survivors will need help caring for themselves, 20% will need help walking, and 71% will have an impaired ability to work when examined 7 years later. As many as 16% will have to be institutionalized.

Yet they are survivors who are more likely to recover from stroke than their male counterparts, possibly because they suffer less brain damage from stroke than do men. One study in female rats reveals that following a stroke, the female rat typically has about one third less brain damage than the male. Researchers theorized that the female hormone estrogen may be benefiting the female rats, and tested the effects of estrogen on female rats following stroke. Rats that received estrogen exhibited about half the amount of brain damage as those in the control group, suggesting a need for further research about ways estrogen might be used to treat stroke.

With studies like these and continued attention to finding new therapies and reducing stroke risks, Americans should be able to prevent 80% of all strokes within the next ten years, scientists at the National Institute of Neurological Disorders (www.ninds.nih.gov) predict.

Women's special risks

Although risk factors for men and women are basically the same, a family history of stroke, high blood pressure, smoking, diabetes, heart disease, and high red blood cell count, some additional risk factors affect only women. For example, a woman's risk of stroke increases during pregnancy, when her blood pressure may go up. A young woman who has migraines and uses oral contraceptive may also be at greater risk for stroke than one who does not use the pill. On the other hand, older women who take estrogen may have a reduced risk of death from stroke, results from the long-term Nurses. Health Study suggest.

As you can see, there really are no absolutes, except for one: leading a healthy lifestyle is your best protection. If you want to reduce your risk of stroke, the American Heart Association suggests the following healthy lifestyle changes:

• If your blood pressure is too high, talk to your doctor about how to reduce it.
• Quit smoking and avoid exposure to second-hand stroke.
• If you have diabetes, keep it under control with diet and prescribed medication.
• Reduce your risk of heart disease by reducing high blood levels of cholesterol and avoiding saturated fats.
• Keep physically active.
• Reduce excess weight or maintain a healthy weight.
• Moderate any use of alcohol: Moderation is the key word when it comes to alcohol. A recent 16-year study of 13,329 Danes found that those who drank one to six glasses of wine a week had a 34% lower risk of stroke than those never or hardly ever drank wine. The same positive results did not hold up for other forms of alcohol. The researchers say that one reason for wines protective effects may be that it contains flavonoids and tannins-nutrients that have been shown to have properties that help inhibit the development of atherosclerosis, the plaque build-up that can cause strokes. But beware! Excessive drinking can lead to a host of health problems, so moderation is the key.

Can you name a stroke symptom?

Even though nearly every one knows someone who has had a stroke, well under one half of Americans are unable to name a single stroke symptom, a panel of experts told the 24th American Heart Association Conference on Stroke and Cerebral Circulation in October 1998. That means when stroke strikes, many are unaware and delay going to the hospital. A study of 272 patients presenting at hospital emergency rooms found mean arrival time at the hospital for women with stroke was 13 hours, and for men 17 hours. Following a public awareness campaign, that time dropped to 5 hours for women, still not good enough. Ideally, a stroke victim will be treated within the hour with tPA, the only approved treatment for acute stroke. That's why it's so crucial to recognize the early warning signs of stroke.

Recognize early warning signs

When your brain is not receiving enough oxygen, it sends clues to your body that a problem exists. Every minute counts! Studies show that brain damage begins from the moment a stroke starts; scientists now know that there is a very short window of opportunity for treatment of the most common form of stroke. Call 911 immediately if you experience:

• Weakness or numbness of the face, arm, or leg on one side of the body
• Dimness or loss of vision, particularly in one eye
• Difficulty speaking or trouble understanding speech
• Sudden severe headache with no known cause
• Unexplained dizziness, unsteadiness or sudden falls, especially with any of the other signs.