Perception of risk and knowledge of risk factors in women at high risk for stroke

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. 805 women, ages 50 to 70, were selected from the University of Connecticut Cardiology Center with at least one risk factor for stroke.

A five-part questionnaire addressed stroke knowledge, risk perception, risk factors, access to health care and demographics. 215 women responded by mail (28% response rate) and de-identified data was entered in SPSS. Descriptive, bivariate and multivariate techniques assessed the proposed model. 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 7 of the 37 (18.9%) women with atrial fibrillation and 11 out 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=.336, p<.001), worrying about stroke (B=.734, p<.001), having hypertension (B=.686, p=.037) and diabetes (B=.893, p=.004).

Only 63.9% of women with atrial fibrillation (n=23) reported taking warfarin. 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.