Generally, women are at a higher risk of having a stroke compared to men. This, according to doctors, is due to increased blood pressure during pregnancy and hormonal imbalances post-menopause. However, contrary to this common phenomenon, in Bhutan, more men seem to be at higher risk of stroke compared to women. This, doctors say, is caused by high blood pressure resulting from risk factors due to lifestyle changes among men. According to data collected by the Bhutan Stroke Foundation, 57.4 per cent of stroke survivors in the country are men compared to 42.6 per cent of women.
Strokes occur when the flow of oxygen and nutrients to the brain is cut off. According to experts, this can happen when the blood vessels get weak and eventually rupture under pressure, known as a hemorrhagic stroke. In more common cases, clots or plaque can block blood vessels to the brain which is known as ischemic stroke. Experts say both types of stroke can lead to permanent damage or death.
According to an international report published by the US Centre for Disease Control and Prevention, stroke is more common in women than men because pregnancy and the use of birth control pills increase the risk of stroke in women.
A doctor from the national referral hospital confirmed that the risk increases in women during pregnancy and menopause.
“During pregnancy, while giving birth to a child, there is always a condition where the blood pressure gets increased a lot, meaning pregnancy-induced hypertension. So, in such scenarios, the risk of women getting stroke increases a lot during pregnancy. Most women, if they are not ready to get pregnant, use contraceptive pills like OCP pills. Even the usage of OCP pills increases the risk of getting a stroke. Now the third one is women who have reached a stage where they do not have a period or a menopausal period. So, during that time, the level of the hormone called oestrogen in women completely decreases a lot. A 60 per cent decrease in this oestrogen level causes an increase in androgen in the body. Such scenarios increase the risk of having a stroke,” said Dr Sonam Jamtsho, Neuro-Spine Surgeon.
However, the doctor added that the differences in the risk of having strokes between males and females are not very high.
According to the World Health Organisation, strokes are caused by two factors such as lifestyle and medical risk factors.
Lifestyle risk factors often referred to as modifiable risk factors include being overweight or obese, physical inactivity, and use of tobacco and alcohol abuse.
Likewise, medical risk factors include high blood pressure, high cholesterol, diabetes and a personal or family history of stroke or heart attack.
WHO says medical intervention, community support and lifestyle modification can prevent at least 50 percent of stroke cases.
Meanwhile, according to the Bhutan Stroke Foundation, most men in the country have lifestyle-related risk factors resulting in more Bhutanese men being affected by stroke compared to women.
“From what I have seen and also according to the risk score survey, one of the reasons is because of obesity or overweight, smoking and drinking, working class people and cholesterol, it is mostly men who fall under such categories. In our country, unlike international reports where women are mostly affected by stroke, it is men who are affected more by stroke,” said Dawa Tshering, Executive Director of the Bhutan Stroke Foundation.
In addition, research by the Bhutan Stroke Foundation found that people aged between 35 and 70 are the ones who mostly suffer stroke. The foundation intends to collect more sample for their research after receiving additional fund and support.
On average, the national referral hospital receives about 15 stroke cases every month.
Singye Dema
Edited by Phub Gyem
