New Guidelines Aim to Lower Stroke Risk in Women
Pregnancy, childbirth, female hormones can all influence lifelong risk, experts say
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But, she added, while complications from stroke are rare during pregnancy, that's when the first signs of vascular disease can appear. She said women who have eclampsia and preeclampsia during pregnancy (a dangerous condition marked by high blood pressure), for example, are at twice the risk for stroke later in life and four times the risk for high blood pressure later.
Bushnell added that taking birth control pills can raise a woman's risk for stroke, especially in middle age. And women who get migraines with aura are also at higher risk, so they need to consider preventive strategies earlier in life.
Some recommendations in the new guidelines include:
- Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin therapy or calcium supplementation while pregnant.
- Pregnant women with elevated blood pressure (150-159 mm Hg/100-109 mm Hg) should talk with their doctor about possible blood pressure medication.
- Pregnant women with severe high blood pressure (160/110 mm Hg or above) should take medication.
- Women should be screened for high blood pressure before taking birth control pills.
- Women who suffer from migraines with aura should quit smoking.
- Women over 75 should be screened for atrial fibrillation risks.
"There isn't a specific prevention strategy for women because we haven't studied it enough to find one," Bushnell said. "But all of the healthy lifestyle recommendations apply equally to men and women."
Dr. Suzanne Steinbaum, director of Women's Heart Health at the Heart and Vascular Institute at Lenox Hill Hospital in New York City, said she hopes the new guidelines will help women be more aware of stroke risk and cardiovascular health.
"Whenever I give a talk, I ask what people think is the greatest risk to women's health and they say breast cancer," Steinbaum said. "I don't think stroke is on the same level of consciousness. Awareness is the first step," she noted.
"The first step is, if you have any risks for cardiovascular disease, heart disease or stroke, it's important to visit your doctor," Steinbaum said. "Then, know your numbers: your blood pressure, your cholesterol, your blood sugar, your BMI [which is a score based on height and weight]. Knowing your family history is also very important. To prevent stroke it comes down to the basics, lifestyle changes. These are critical issues to address in order to reduce cardiovascular disease and prevent stroke."