New Guidelines Address Stroke Risk in Women

(April 29, 2014) - Stroke is the third leading cause of death for women in our country, right on the heels of heart attack and cancer. Women have an even greater risk of stroke than men. For the first time, the American Heart Association/American Stroke Association has issued guidelines specifically aimed at stroke prevention in women. These guidelines were developed to help primary care doctors and gynecologists better identify women at risk.

To help prevent a stroke, it is vital to maintain a normal blood pressure, healthy cholesterol levels, a healthy weight, and to abstain from smoking. It is also important to exercise regularly, eat whole foods, and limit processed sugar and processed foods. In addition to these basic lifestyle choices, there are some risk factors that are unique to women -- factors influenced by hormones, reproductive health, pregnancy, and childbirth, to name a few.

First, women of reproductive age who have high blood pressure should consider low-dose aspirin, calcium supplementation, or both to reduce the risk of preeclampsia. Preeclampsia is a condition that develops during pregnancy and causes high blood pressure and protein in the urine. Women with preeclampsia are twice as likely to have a stroke and four times as likely to develop high blood pressure later in life compared to women who do not develop preeclampsia.

Because preeclampsia considerably increases later risk of stroke, women with this condition should follow-up with their doctor six months and one year after childbirth. In addition, preeclampsia should be documented and treated as a significant stroke risk factor, similar to high cholesterol, high blood pressure, smoking, and obesity.

If you have high blood pressure and may become pregnant, talk to your doctor about whether a low-dose aspirin or calcium supplement regimen is appropriate for you. If you've ever had preeclampsia, make sure your primary care doctor knows this and talks to you about your stroke risk.

A second new guideline states that pregnant women with moderately high blood pressure (150-159/100-109) may be candidates for blood pressure medication, while those with severe high blood pressure (greater than160/110) should be treated.

Lastly, women who take oral contraceptives should be screened for high blood pressure as the combination of elevated blood pressure and birth control pills significantly increases the risk of stroke. If you are using oral contraceptives, talk to your doctor about how to maintain a healthy blood pressure.

These new guidelines address key issues that place women at a higher stroke risk than men. Your physician is your partner in reducing your stroke risk. Talk with him or her about your risk and maintain open, honest communication for a lifetime of good health.

About the Author: Jessica Friedland Carter, M.D., grew up in Cleveland and attended the Medical College of Ohio. She moved to Atlanta to complete her residency in neurology at Emory University Hospital. She then completed fellowship training in neurophysiology at Emory University Hospital. She currently practices at Savannah Neurology Specialists. Outside of work, she enjoys spending time with her husband and two children, and practicing yoga.