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It's one of the leading causes of death among women in the United States, yet many cannot identify some of the most common signs of a stroke, according to a new study led by investigators from NewYork-Presbyterian Hospital and Columbia University Medical Center. The study was presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2014 Scientific Sessions and appears in the association's journal, Stroke.

"We found that women who think they are having a stroke are likely to take the appropriate action to call 911 but many don't know the warning signs of a stroke, so they wouldn't know when to call," said the study's principal investigator, Dr. Lori Mosca, director of preventive cardiology at NewYork-Presbyterian/Columbia and professor of medicine at Columbia University Medical Center. "The findings are concerning and reveal a major gap in knowledge on a very serious subject. We need to concentrate our efforts on educating women to know what a stroke looks and feels like. That knowledge could be lifesaving."

Funded in part by a National Institutes of Health career award granted to Dr. Mosca (5K24HL076346-09), phone surveys collected demographic information and answers to open-ended questions about stroke awareness from 1,205 English-speaking women 25 and older.

The respondents' answers revealed that the majority of women, regardless of race and ethnicity, knew to call 911 first if they thought they were experiencing signs of a stroke. Most of the women, however, might not be able to recognize those signs if they were experiencing them.

Only about half of women surveyed (51 percent) identified the classic symptom of sudden weakness/numbness of face/limbs on one side as a stroke warning sign; a slightly smaller percentage (44 percent) knew that loss of/trouble talking/understanding speech is a warning sign. This symptom was identified more by white women (48 percent) than by Hispanic women (36 percent).

More alarming, however, the survey revealed that fewer than one in four women could identify some of the most common warning symptoms of stroke, including sudden, severe headache (23 percent), unexplained dizziness (20 percent), or sudden dimness/loss of vision (18 percent).

Twenty percent could not identify a single warning sign.

This lack of recognition of stroke signs and symptoms could be a significant barrier to reducing death and disability, Dr. Mosca said. "This is critically important because the early recognition of stroke warning signs at their onset speeds access to emergency care. Delays in getting care cost lives and hinder functional recovery."

Stroke is the fourth-leading overall cause of death in the United States and the third-leading cause among women. It affects roughly 55,000 more women than men each year, and recent data show a rise in stroke prevalence among middle-aged women not seen among their male counterparts.

Minority racial and ethnic groups, including blacks and Hispanics, are also at higher risk of stroke. For those who survive, many will suffer long-term disabilities requiring a caretaker or institutional help.

The researchers urge the development and promotion of effective clinical counseling strategies and public awareness campaigns to reach diverse populations of women in an effort to address the knowledge gap. Lead author Dr. Heidi Mochari-Greenberger, an epidemiologist at Columbia University Medical Center, said, "Given the high level of knowledge to call 911, these results suggest that efforts to improve recognition of stroke warning signs have the potential to contribute to reduced treatment delay and improved outcomes in women."

The authors declare no financial or other conflicts of interest.

NewYork-Presbyterian Hospital/Columbia University Medical Center

NewYork-Presbyterian Hospital/Columbia University Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and its academic partner, Columbia University College of Physicians and Surgeons. NewYork-Presbyterian/Columbia provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian Hospital/Westchester Division, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian/Lower Manhattan Hospital. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S. News & World Report. For more information, visit www.nyp.org.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.