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New Guidelines for Reducing Stroke Risks in Women

Gender-related factors play a role (January 6)

For the first time, a scientific statement from the American Heart Association and the American Stroke Association has provided guidelines for preventing stroke in women.

According to the statement’s lead author, Cheryl Bushnell, MD, MHS, women share many of the same risk factors for stroke with men, but their risk is also influenced by hormones, reproductive health, pregnancy, childbirth, and other gender-related factors.

The new guidelines outline stroke risks unique to women and provide scientifically based recommendations on how best to treat them, including:

  • Women with a history of hypertension 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 hypertension later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors in these women, such as smoking, high cholesterol, and obesity, should be treated early.
  • Pregnant women with moderately high blood pressure (150–159/100–109 mm Hg) may be considered for blood pressure medication, whereas expectant mothers with severe hypertension (160/110 mm Hg 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 the age of 75 should be screened for atrial fibrillation risks because of its link to higher stroke risk.

The guidelines are geared to primary care providers, including Ob-Gyns.

Source: AHA; February 6, 2014.

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