Stroke risks in women with dysmenorrhea by age and stroke subtype

Abstract

BackgroundDysmenorrhea and stroke are health problems affecting women worldwide in their day-to-day lives; however, there is limited knowledge of the stroke risk in women with dysmenorrhea, and there have been no studies assessing the specific distribution of stroke subtypes. This case-control study assessed stroke subtypes by age and the role of comorbidities in women with dysmenorrhea.Methods and findingsData obtained between 1997 and 2013 from Taiwan’s health insurance database identified 514 stroke cases and 31,201 non-stroke controls in women with dysmenorrhea aged 15–49 years. Proportional distributions of subtypes and odds ratios (ORs) of stroke associated with comorbidities by age and subtype were measured. We found that the stroke risk in dysmenorrheal patients increased with age, and that hypertension was nine-fold more prevalent in the stroke cases than in the controls and was associated with an adjusted OR of 4.53 (95% confidence interval (CI) = 3.46–5.92) for all stroke cases. Moreover, the proportion of hemorrhagic stroke was greater than that of ischemic stroke in younger dysmenorrheal patients between 15–24 years old (50.5% vs. 11.4%), whereas this was reversed in those aged 30–49 years old (16.1% vs. 21.0%). Overall, 25.3% of the stroke cases consisted of transient cerebral ischemia and 31.3% were other acute but ill-defined cerebrovascular diseases, in which the prevalence increased with age for both types of strokes. Hypertension was the comorbidity with the highest OR associated with each subtype stroke; diabetes, hyperlipidemia, arrhythmia, and thyroid disease were also comorbidities that were significantly associated with ill-defined cerebrovascular diseases.ConclusionsThe stroke type varies by age in dysmenorrheal patients, and hypertension is the most important comorbidity associated with all types of stroke; therefore, more attention for stroke prevention must be paid to women with dysmenorrhea, particularly when combined with comorbidities.

The Relationship between Pain and Vascular Function Biomarkers in Dysmenorrheal University Students

“… 7 Attempts have been made in previous studies to understand if dysmenorrhea predisposes women to vascular complications such as high blood pressure, hypertension, and stroke, but whether the severity of dysmenorrhea correlates to the susceptibility to these vascular complications remained unexplained. 8 9 10 Based on this, we conducted this study using female university students to first establish the reliability of a pain biomarker, contactin 1, for the assessment of the severity of dysmenorrhea, by correlating with the NRS-11 pain scale of each participant, and also correlated with the biomarkers of vascular health; the vascular cell adhesion molecule 1 and angiotensin II.…”

Medical Costs of Stroke Care Between Women With and Without Dysmenorrhea: A Population-Based Comparison

“…Although stroke and dysmenorrhea are related to mutual risk factors, few researchers have investigated the association between the two conditions. A recent case-control study using insurance-claim data of women with dysmenorrhea in Taiwan suggested that stroke-related disorders are more prevalent in stroke cases than in nonstroke controls (21) Stroke can result in physical disability and dependence on others, both of which impose high economic costs (2). Stroke costs an estimated $34 billion each year in the United States (22).…”

“…It should, however, be noted that it remains unclear how the occurrence of stroke among women with dysmenorrhea affects the cost of care. Few studies have evaluated whether the stroke types and costs in women with dysmenorrhea differ from those in women without dysmenorrhea (21). The occurrence of dysmenorrhea and stroke varies by age (3).…”

Population-based Comparison Study on the Costs of Stroke Care for Women with Dysmenorrhea

“…Although stroke and dysmenorrhea are related to mutual risk factors, few researchers have investigated the association between the two conditions. A recent case-control study using insurance-claims data of women with dysmenorrhea in Taiwan suggested that stroke-related disorders are more prevalent in stroke cases than in non-stroke controls [20]. The disorders included hypertension (adjusted odds ratio [ Stroke can result in physical disability and dependence on others, both of which impose high economic costs [2].…”

“…It should, however, be noted that it remains unclear how the occurrence of stroke among women with dysmenorrhea affects the cost of care. Limited study has evaluated whether the stroke types and costs in women with dysmenorrhea differ from those in women without dysmenorrhea [20]. The occurrence of dysmenorrhea and stroke vary by age [3].…”