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Why young women are at a higher risk for strokes

Real Housewives star Kim Zolciak-Biermann was just 37 when she suffered a stroke last fall. Like 5 to 10 percent of the population, she was born with a malformation in her heart (in her case, a hole), not even realizing she had a problem until she was going into emergency surgery. The experience, she says, changed everything.

“It’s a process. It really changes you. I couldn’t give two shits about some of the things I used to care about, like people’s rude comments on Instagram. My husband and kids are all that matter,” Zolciak-Biermann told In Touch. “It could’ve been the end of the road for me, so I just enjoy every single moment with them.”

But aren’t strokes, well, a thing that only happens to old people? How did this even happen to a young mother in the prime of her life?

“It’s a lot more common than you think,” says cardiologist Nicole Weinberg, M.D. at Providence Saint John’s Health Center in California. “In the past, some of these strokes used to be written off, but now, with technology, we can see exactly what’s happening.”

More: 6 heart attack symptoms that are different in women

And what’s happening is that premenopausal women are at an elevated risk for certain types of strokes thanks to — you guessed it! — hormones.

“Higher hormone levels, particularly estrogen, compromise the integrity of blood vessels,” Weinberg explains. “They affect how they stretch and contract, which can make them more vulnerable to arterial dissection [tears] and blood clots.”

This risk is magnified for women on birth control pills and women who smoke, use illegal drugs or are pregnant, she says. Any of these combined further increases your risk, hence the warning against smoking on every pack of birth control pills.

There are three main types of strokes that Weinberg says younger women should be concerned about. The first — physical tears in a blood vessel — happen quickly, can’t be prevented or prepared for and are often catastrophic. It leads to bleeding in the brain and can lead to death very quickly unless you receive emergency care.

“These happen before anyone even realizes anything is wrong — the patient just collapses,” she says. “A person may not complain of anything, and there aren’t a lot of warning signs.”

More: 5 ways to cut your heart disease risk in half

Sometimes they happen just because life is cruel like that, but they can also be instigated by a vigorous neck massage (Weinberg recommends not letting anyone massage the front or sides of your neck, where your carotid arteries are), placing the neck in an unnatural position (some women have reported strokes after having their hair washed in a sink at a salon) or some other injury to the neck.

The second is when a blood clot “knocks off” and gets lodged somewhere. These are the most easily identified, she says, and are the type caused by smoking, drugs and the birth control pill. So while you can’t prevent them entirely, you can take steps to reduce your risk, particularly if you have a family history of stroke.

The last type is caused by a narrowing of the blood vessels, mostly from lifestyle choices, like eating a poor diet, being overweight, having high blood pressure or not exercising. These are the most preventable and the kind most under your control by making healthy lifestyle choices and staying current on your checkups.

Symptoms of a stroke, according to the American Heart Association, include sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing or blurred vision in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden severe headache with no known cause. If you experience any of these symptoms, call your doctor, or go to the emergency room immediately.

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