Stoke Prevention Guidelines for women have just been issued by the American Heart Association / American Stroke Association (AHA/ASA) to reduce their risk of stroke. The issue of how men and women differ in their stroke risks has long been discussed so these guidelines are welcomed. The stroke prevention guidelines were published in a recent issue of Stroke and set forth methodology to determine a stroke risk score specifically for women. Each year, there are 55,000 more strokes in women than men. While stroke is the 5th leading cause of death in men, it is the 3rd leading cause of death in women. The guidelines point out that it critical to identify women at risk for stroke and to implement preventive care.
Certain risk factors are unique to women. Pregnancy, oral contraceptives and hormone replacement therapy increase the risk of stroke in women. Certain medical conditions which are associated with strokes, such as migraine with aura and cerebral vein thrombosis , are more common in women. Pre-eclampsia in pregnancy is associated with a doubling of a woman’s risk for stroke later in life, even if blood pressure returns to normal after the pregnancy. Women who had pre-eclampsia during pregnancy are at higher stroke risk and need to be screened for blood pressure more frequently and at an earlier age, even if the pre-eclampsia occurred over 40 years ago. Women with a history of high blood pressure before pregnancy should be considered for low dose aspirin and calcium therapy to decrease pre-eclampsia risk.
The stroke prevention guidelines for women advise doctors to be more aware of the risk of stroke in women and how risk factors can add up. When guidelines are not followed and there is a failure to diagnose stroke or to reduce risk factors that can cause stroke, the outcome can be catastrophic for both the woman and her family. A female specific stroke score helps identify women at risk and can allow the institution of risk reduction therapy.