Women may be known as the fairer sex, but when it comes to stroke risk, things may not be so, well, fair. In addition to the risks everyone faces, women have a number of added risk factors unique to their sex.
To help women reduce that risk, the American Heart Association/American Stroke Association gathered a group of researchers and asked them to develop the first set of guidelines for the prevention of stroke in women.
“The American Heart Association has excellent stroke prevention guidelines, [but] there has never been one that has focused on the unique risks in women,” Louise McCullough, one of the authors of the guidelines, told TheDoctor.
Women have multiple factors — hormones, pregnancy, and childbirth — that put them at increased risk for stroke, she explained, but too few women think about this as much as they should.
Women with pregnancy-associated complications, such as pregnancy-induced diabetes and pregnancy-induced hypertension, need to be more aggressive about getting screened.
In addition to outlining the stroke risks that are unique to women, the guidelines also recommend ways women can address them.
For example, women with a history of hypertension should consider taking low-dose aspirin and/or calcium supplements to lower their risk of preeclampsia during pregnancy. In fact, preeclampsia should be recognized as a risk factor even long after a woman’s childbearing years are over. This is because those who have had it have twice the risk of stroke and quadruple the risk of hypertension later in life.
Women who have had preeclampsia and also have one or more conditions known to contribute to stroke — such as smoking, high cholesterol, and obesity — should be treated early.
The guidelines also recommend that blood pressure medication should be considered for pregnant women with moderately high blood pressure (150-159 mm Hg/100-109 mm Hg); those with very high blood pressure (160/110 mm Hg or above) should definitely be treated.
Likewise, for women who have migraine headaches with aura it's a good idea to quit smoking to avoid increasing your stroke risk; and women over age 75 should be screened for atrial fibrillation because it, too, is associated with an increased risk of stroke.
The best way for women to prevent stroke or reduce their risk is to follow the same prevention measures that are recommended for men, says McCullough, a professor of neurology and neuroscience and a physician at the stroke center at Hartford Hospital; and the most important thing is to be screened for high blood pressure, and treat it if you have it.
If you smoke, try to quit. If you don’t exercise regularly, or have diabetes, control these risk factors with weight loss and medications. And start walking.
Women who develop pregnancy-associated complications, such as pregnancy-induced diabetes and pregnancy-induced hypertension, are at greater risk for having a stroke later in life. If this is your situation you need to be more aggressive about getting screened.
You should definitely tell your doctor if you have ever had pregnancy-associated hypertension, or pregnancy-associated diabetes, or if you are a smoker, or if you get migraines with aura, says McCullough. Be sure to tell your primary care physician, even if you are being treated by an obstetrician/gynecologist.
The guidelines were published online recently in Stroke.