The Crystal Ball of Stroke Prevention May Be Changing For Postmenopausal Women

by Alysia Drummond on February 7, 2012

It seems everywhere I go women around me are discussing “the change,” when the days of cramps and tampons give way to hot flashes and night sweats.  Along with menopause comes an increased risk for stroke and heart disease.  Physicians monitor these changes and their effects on women’s health via blood work and lifestyle factors.  In the case of stroke prevention, much of the focus is currently on cholesterol.  While cholesterol levels may be an accurate predictor of stroke risk among some populations, a new study claims post-menopausal women aren’t one of them.  Instead, triglyceride levels may be a more accurate predictor in these women.

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This prospective case-control study looked at 1,548 post-menopausal women (774 stroke patients and their controls), and was the first to evaluate triglycerides as a stand-alone method for determining the risk of ischemic (meaning caused by a blood clot as opposed to a brain bleed) stroke.  Results of the study indicated that the odds of women whose triglycerides were in the highest group (>192 mg/dL) experiencing a stroke were 56% greater than women whose triglycerides were in the lowest group (<104 mg/dL).  Total cholesterol, HDL (good) cholesterol, and LDL (bad) cholesterol are often used as indicators of ischemic stroke risk, but were not found to be predictive of stroke in these women.

The reasoning behind these findings is not well understood.  It may be that thicker artery walls develop with high triglyceride levels.  Or that high triglycerides trigger blood-clotting abnormalities.  The researchers of this study state there are probably multiple changes happening in the presence of high triglycerides and that it’s a combination of these changes that lead to ischemic stroke.

More research is needed to replicate this finding before changes are seen in clinical settings.  In the mean time, we’re left with the cholesterol, an imperfect measure.  So what does all of this mean?  Although the pharmaceutical aspect of stroke prevention may change, the lifestyle factors remain the same.  A healthy diet filled with fruits, vegetables, and whole grains paired with an active lifestyle is still the key to ward off stroke.


Berger, J.S., McGinn, A.P., Howard, B.V., Kuller, L., Manson, J.E., Otvos, J., Curb, D., Eaton, C.B., Kaplan, R.C., Lynch, J.K., Rosenbaum, D.M., Wassertheil-Smoller, S. (2012). Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women. Stroke, 43.  DOI: 10.1161/​STROKEAHA.111.641324