The guidelines outline stroke risks unique to women
and provide scientifically-based recommendations on how best to treat
Women with a history of high blood pressure
before pregnancy should be considered for low-dose aspirin
and/or calcium supplement therapy to lower preeclampsia risks.
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
risks due to its link to higher stroke risk.
Preeclampsia and eclampsia are blood pressure
disorders during pregnancy that cause major complications, including
stroke during or after delivery, premature birth, and risk for stroke
well after child-bearing. Preeclampsia is characterized by high blood
pressure and high protein levels in the urine, and when seizure also
occurs, this is called eclampsia.
High blood pressure, migraine with aura, atrial
emotional stress are
stroke risk factors that tend to be stronger or more common in women
than in men.
More studies need to be done to develop a
female-specific score to identify women at risk for stroke, said
Bushnell, associate professor of neurology and director of the Stroke
Center at Wake Forest Baptist Medical Center in Winston-Salem, N.C.
Co-authors are Louise McCullough, M.D., Ph.D.;
Issam Awad, M.D., M.Sc.; Monique Chireau, M.D., M.P.H.; Wende Fedder,
D.N.P., R.N.; Karen Furie, M.D., M.P.H.; Virginia Howard, Ph.D., M.S.P.H.;
Judith Lichtman, Ph.D., M.P.H.; Lynda D. Lisabeth, Ph.D., M.P.H.; Ileana
Piña, M.D., M.P.H.; Mathew Reeves, Ph.D., D.V.M.; Kathryn M. Rexrode,
M.D., M.P.H.; Gustavo Saposnik, M.D., M.Sc.; Vineeta Singh, M.D.; Amytis
Towfighi, M.D.; Viola Vaccarino, M.D., Ph.D.; and Matthew Walters, M.D.,