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New guidelines focus on preventing stroke in women

Friday February 7, 2014
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Clinical experts have issued the first guidelines for preventing stroke in women.

“If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” Cheryl Bushnell, MD, MHS, author of the guidelines, said in a news release.

The guidelines, published Feb. 6 on the website of the journal Stroke, outline stroke risks unique to women and provide scientifically-based recommendations on how best to treat them:

• Women with a history of hypertension before pregnancy should be considered for low-dose aspirin or calcium supplement therapy to lower preeclampsia risks.

• Women with preeclampsia have twice the risk of stroke and a four-fold risk of hypertension 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 moderate hypertension (150-159 mmHg/100-109 mmHg) may be considered for blood pressure medication, whereas expectant mothers with severe hypertension (160/110 mmHg or above) should be treated.

• Women should be screened for hypertension 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.

Preeclampsia and eclampsia cause major complications, including stroke during or after delivery, premature birth and risk for stroke well after child-bearing. Hypertension, migraine with aura, atrial fibrillation, diabetes, depression and emotional stress are stroke risk factors that tend to be stronger or more common in women than in men, according to the guidelines.

More studies need to be done to develop a female-specific score to identify women at risk for stroke, said Bushnell, associate professor of neurology and director of the Stroke Center at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

The guidelines are geared to primary care providers, including OBGYNs, according to the news release.

Guidelines: https://stroke.ahajournals.org/content/early/2014/02/06/01.str.0000442009.06663.48.abstract


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