The American Heart Association/American Stroke Association have created guidelines for health care professionals for the prevention of stroke in women for the first time. The new recommendations have recently been published in the journal Stroke.
Approximately 795,000 Americans suffer from a new or recurrent stroke every year, with 60% of stroke deaths occurring in women.
But Dr. Cheryl Bushnell, of the Stroke Center at Wake Forest Baptist Medical Center in North Carolina and co-author of the new guidelines, notes that women's risk of stroke can also be influenced by other factors, including hormones, reproductive health, pregnancy and childbirth.
The new guidelines have been developed to take these factors into consideration.
To reach the recommendations, the committee chair of the American Heart Association (AHA) nominated a panel of health care professionals based on their previous work in relevant topic areas.
In May last year, the panel reviewed a series of studies associated with the risk of stroke in women.
They found that high blood pressure, migraine with aura, diabetes, atrial fibrillation, depression and emotional stress are all risk factors for stroke that are more common among women than men.
The new guidelines recommend that women who have preeclampsia during pregnancy should be treated for obesity, smoking and high cholesterol.
Preeclampsia and eclampsia are blood pressure disorders that can occur before or just after pregnancy. These conditions can cause severe complications for women, such as premature birth, stroke during or after delivery, and increased risk of stroke after birth.
New guidelines for stroke risk in women
Their analysis led to the development of a set of guidelines aimed at health care professionals, in an attempt to reduce stroke risk for women. These include the following:
- Before taking birth control pills, women should be screened for high blood pressure because of the associated increased stroke risk.
- Women who suffer from migraine headaches with aura should stop smoking to reduce stroke risk.
- Low-dose aspirin and/or calcium supplement therapy should be considered for women with a history of high blood pressure before pregnancy in order to reduce preeclampsia risk.
- Preeclampsia should be seen as a risk factor for stroke long after pregnancy, since women who have the condition have twice the risk of stroke and four times the risk of high blood pressure later in life.
- Women who have preeclampsia should be treated early for obesity, smoking and high cholesterol.
- Women over the age of 75 should be screened for atrial fibrillation because of its association with increased stroke risk.
- Pregnant women with severe high blood pressure (160/110 mmHg or above) should be treated with blood pressure medication, while expectant mothers with moderately high blood pressure (150-159 mmHg/100-109 mmHg) should be considered for treatment.
The panel says that further studies are required in order to determine the risk of stroke in individual women.
The authors conclude:
"To more accurately reflect the risk of stroke in women across the lifespan, as well as the clear gaps in current risk scores, we believe a female-specific stroke risk score is warranted."
Since its launch in 2003, the AHA state that 23% more women now realize that heart disease in the number one killer in females, while 15% of women have quit smoking and high cholesterol levels have declined by 18%.
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