First Guidelines for Reducing Stroke Risks in Women Released

The first guidelines specific to women for preventing strokes have been issued by the American Heart Association/American Stroke Association.  These guidelines include descriptions of stroke risks that are unique to women with evidence-based recommendations for prevention, including:

  • Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks.
  • Women who have preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol, and obesity in these women should be treated early.
  •  Pregnant women with moderately high blood pressure (150–159 mmHg/100–109 mmHg) may be considered for blood pressure medication, whereas expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
  • Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.
  • Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
  • Women over age 75 should be screened for atrial fibrillation risks due to its link to higher stroke risk.

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Many of these conditions are stroke risk factors that are often more pronounced or more common in women than in men. Cheryl Bushnell, MD, MHS of the Stroke Center at Wake Forest Baptist Medical Center in Winston-Salem, NC and one of the guideline authors states that while men and women share many stroke risk factors, hormones, reproductive health, pregnancy, childbirth, and other sex-related factors also impact risk factors in women. Because of this, additional studies are needed to develop identification of women at risk for stroke via a female-specific score.

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Image courtesy of the American Heart Association/American Stroke Association