Making History: Women and Stroke
Last week, the American Heart Association/American Stroke Association released a new set of stroke prevention guidelines. The announcement was a major milestone for the organization – marking the first time that stroke prevention guidelines have been released specifically for women.
The guidelines were published in the American Heart Association journal, Stroke, and according to lead author and neurologist Cheryl Bushnell, “The risk factors that are unique to women need to be recognized, and women can start decreasing their risk much earlier than they thought, even in the childbearing years.”
For physicians and other medical professionals, the fact that more women face a higher risk for stroke than men, and that approximately half of strokes occur in women, is well documented. However, such statistics are often surprising to the general public, which is why we at University of Utah Health Care applaud the Association’s decision to release the guidelines and increase awareness specifically to the female population.
What are the New Guidelines?
The new guidelines outline women's stroke risks and offer advice on treating them:
- Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower pre-eclampsia risks.
- Women who have pre-eclampsia have twice the risk of stroke and a four-times the risk of high blood pressure later in life. Pre-eclampsia should be recognized as a risk factor for stroke, and other risk factors such as smoking, high cholesterol and obesity in these women should be treated early. Bushnell says women who have had pre-eclampsia should be proactive in informing their doctors of this previous medical condition and start the conversation of stroke-risk assessment.
- Women should be screened for high blood pressure before taking birth control pills as the combination of the two greatly increases stroke risks.
- Pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) may be considered for blood pressure medication. Expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated with medication during pregnancy.
- Women who have migraine headaches with aura should stop smoking to avoid multiplicative stroke risks.
- Women over age 75 should be screened for atrial fibrillation due to its link to higher stroke risk.
Back to Basics: What is Stroke?
With increased efforts by organizations throughout the country to educate the public about recognizing the signs of a stroke, it is still the fourth leading cause of death in the United States, and the third leading cause of death in Utah.
Also called brain attack, stroke occurs when blood flow to the brain is disrupted, caused when either a blood clot or piece of plaque blocks one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke). In these cases, the affected part of the brain stops receiving vital oxygen and blood and begins to die. The results can be lasting and permanent, affecting language, memory and vision, as well as causing paralysis and other health issues.
Stroke is the fourth-leading cause of death in the United States and a leading cause of disability. Know these warning signs of stroke and teach them to others. Remember, every second counts even if the symptoms subside.
• FACE - Does one side droop?
• ARMS - Does one arm drift downward?
• SPEECH - Are words slurred or mispronounced?
• TIME - Time lost is brain lost. Call 911 immediately if you experience any of these symptoms.
For more information about the Stroke Center at University of Utah Health Care, visit stroke.uofuhealth.org
About the author:
Dr. Wold is an assistant professor of Neurology at the University of Utah, the stroke director for the VA Hospital, vice-chair of the Utah Stroke Task Force and program director for the Adult Neurology Residency. Her clinical practice includes evaluating and treating acute strokes in the hospital and emergency department as part of the Brain Attack team, and over the camera through the use of telemedicine. She manages patients on the inpatient general neurology service, and provides outpatient consultation in the stroke clinic. She additionally staffs the General Neurology resident continuity clinic, the stroke clinic at the VA Hospital.comments powered by Disqus