Abstract WP39: Stroke Risk Factor and Prevention Considerations in Women Veterans

Background: Stroke is a significant health burden for Veterans and the fifth leading cause of death for women. Beyond traditional stroke risk factors, female sex hormones and pregnancy exposures are risk factors for women. Compared to civilian women, women Veterans have significant multimorbid physical and mental health conditions contributing to their stroke risk. Stroke risk factors specific to women Veterans have not been elucidated.

Purpose: This scoping review aimed to summarize evidence on the stroke risk factors specific to United States women Veterans.

Methods: The search strategy was run across six databases: MEDLINE and EMBASE via Ovid, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov. A total of 1,218 records were uploaded to Covidence for screening. Criteria for included studies were peer-reviewed primary research and articles written in English about women Veterans and cardiovascular disease and stroke risk factors. No restrictions were placed on publication date.

Results: Seventeen articles met inclusion criteria. Cohorts were 30 years and older. Data originated from national and individual Veterans Affairs studies. When comparing White Veterans and civilian counterparts, Black Veterans had a higher incidence of stroke; stroke incidence was higher in Veterans with post-traumatic stress disorder with insomnia, restless leg syndrome, traumatic brain injury, constipation with laxative use, egg consumption, frailty, and systemic sclerosis. Women Veterans, starting at age 30, had steadily increasing positive association with stroke risk indicating a need to screen earlier than recommended 45 years of age.

Conclusions: Research is needed on stroke risk factors specific to the female sex as they connect to Veteran exposures (chemical, physical, and environmental). Nurses play a crucial role in interdisciplinary collaboration to recognize and support risk factor reduction for stroke prevention. The knowledge gained from this scoping review helps identify and treat women Veteran's specific stroke risk factors. This, in turn, can reduce the incidence of stroke and help reach equitable sex-specific care that women Veterans need.