U.S. group issues stroke prevention guidelines just for women

While stroke is common in both men and women, guidelines released on Thursday for the first time address factors such as pregnancy, birth control pills and menopause that put women at particular risk for the deadly condition.

Issued by the American Heart Association and the American Stroke Association, the guidelines are designed to help doctors and patients recognize stroke risk factors early, when there is time to act.

"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 Dr Cheryl Bushnell, author of the new scientific statement published in the American Heart Association journal Stroke.

According to the report, stroke is the fifth-leading cause of death in men and the third-leading cause of death in women. Shared risk factors for stroke include high blood pressure, high cholesterol and smoking.

But other factors influence stroke risk in women. Many of these involve pregnancy. For example, women with a history of high blood pressure should take extra steps to control it during pregnancy, such as taking low-dose aspirin and possibly a calcium supplement. That helps reduce the risk of preeclampsia, a condition marked by high blood pressure and protein in the urine that can cause stroke during or after delivery and premature birth.

Women who have had preeclampsia have twice the risk of a stroke and four times the risk of high blood pressure later in life. As a result, they should address issues such as smoking, high cholesterol and obesity, which heighten their stroke risk even more.

Likewise, women should be screened for high blood pressure before using birth control pills, because that combination raises stroke risks.

Other risk factors more common in women than men include migraine with aura, atrial fibrillation, diabetes, depression and emotional stress.

Stroke is a condition with high incidence and mortality rates, leaving a large proportion of survivors with significant residual physical, cognitive, and psychological impairments. The increasing number of older adults and the emergence of new therapies for acute stroke suggest there will be an increase in the number of stroke survivors living with disabilities. Furthermore, secular trends in stroke severity document a decrease in those most severely affected. This shift to more moderately affected survivors places increased demands on rehabilitation efforts and services, making the issue of how to best limit stroke-related disability and health risks a major concern for healthcare providers in rehabilitation. At this time efforts to prevent stroke must be balanced with the pragmatic effort to prevent disability and maximize quality of life for those who have suffered the consequences of stroke.