New Guidelines for Preventing Stroke in Women

By Jane Farrell

For the first time, researchers have developed guidelines for preventing women from having strokes.

"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," said Cheryl Bushnell, M.D., M.H.S., author of the statement published in the American Heart Association journal Stroke.

The guidelines outline stroke risks for women women and provide recommendations on how o treat them, including:

Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower risks of preeclampsia, a condition in which a woman develops high blood pressure and protein in the urine during the second and third trimesters of pregnancy.

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

Women should be screened for high blood pressure 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.

Bushnell, associate professor of neurology and director of the Stroke Center at Wake Forest Baptist Medical Center in Winston-Salem, N.C., said further research needs to be done to determine a female-specific “score” of calculating stroke risk.