“If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth, and other sex-related factors,” said Cheryl Bushnell, MD, lead author of the guidelines. Dr. Bushnell is an Associate Professor of Neurology and Director of the Stroke Center at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.

The new guidelines were recently published in the journal Stroke.

The guidelines detail risks for strokes that are distinctive to women, and the authors give evidence-based recommendations on how to reduce the risks. For example, they suggest that women with a history of high blood pressure before pregnancy be considered for low-dose aspirin or calcium supplement therapy to lower the risk of pre-eclampsia.

Because women with pre-eclampsia have twice the risk of stroke and a fourfold risk of high blood pressure later in life, the guidelines recommend that pre-eclampsia be recognized as a risk factor well after pregnancy.

Migraine with aura, high blood pressure, diabetes, atrial fibrillation, and emotional stress are stroke factors that tend to be stronger or more common in women than in men.

A healthy lifestyle that includes whole foods, exercise, and abstaining from tobacco lowers stroke incidence in men and women. In addition, the guidelines recommend that women with migraine with aura stop smoking to avoid higher stroke risks.

“There is a need for recognition of women’s unique, sex-specific stroke risk factors, and a risk score that includes these factors would thereby identify women at risk,” said Dr. Bushnell. “Similarly, it is important to improve stroke awareness and provide more rigorous education to women at younger ages, including childbearing ages.”     Neurology Reviews     March 2014

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