Just for women: New guidelines for preventing stroke

For the first time, the American Heart Association/American Stroke Association has released stroke prevention guidelines specifically developed for women.

On average, women in the United States have 55,000 more strokes every year than do men. That’s partly because women live longer, and the risk of a stroke increases with age, according to the guidelines. But women also have unique stroke risks.

“If you are a woman, you share many of the same risk factors for stroke with men, but your risks are also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” said Cheryl Bushnell, MD, who wrote the guidelines published in the journal Stroke.

Pregnant women, for example, can develop pre-eclampsia, a complication characterized by high blood pressure and protein in the urine. It doubles the risk of a stroke later in life—a risk that can persist up to 30 years after childbirth, according to the guidelines. Taking birth control pills raises stroke risk in women who already have high blood pressure.

Moreover, several of the stroke risk factors that men and women do share either occur more often in women or are especially dangerous for women. These include high blood pressure, migraines with an aura, diabetes, depression and an abnormal heart rhythm known as atrial fibrillation.

Stroke is the third leading cause of death for women. In an effort to reduce that number, the guidelines recommend that:

  • Women with a history of high blood pressure before pregnancy should be considered for therapy with low-dose aspirin or calcium supplements, either alone or in combination with each other, to lower the risk of pre-eclampsia.
  • Pre-eclampsia should be recognized as an independent risk factor for stroke later in life.
  • Women should be screened for high blood pressure before taking birth control pills.
  • Women over 75 should be screened for atrial fibrillation.
  • Women who have migraine headaches with auras and who smoke should stop smoking.
  • Pregnant women with moderately high blood pressure (150 to 159 mm Hg systolic or 100 to 109 mm Hg diastolic) may be candidates for blood pressure medication, and those with more severe high blood pressure should be treated with medicine.

You can find out your risk factors for stroke by taking this risk assessment.

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