TUESDAY, June 17, 2014 (HealthDay News) -- Stroke typically
affects women in their later years, but doctors are now beginning
to focus on helping them cut their risk earlier in life.
This increased attention to risk factors in early adult years
was recommended by new guidelines that were released earlier this
year by the American Heart Association and the American Stroke
Those guidelines are now being phased into practice by primary
care doctors, experts say. For women, that translates to more
screening for risk factors during office visits and more
interventions to ensure a healthy lifestyle to reduce stroke risk,
said Dr. Louise McCullough, director of the Stroke Center at the
University of Connecticut in Farmington.
McCullough is the co-author of a summary of the guidelines that
was published June 16 in the
Annals of Internal Medicine.
Stroke is a serious interruption or reduction of blood flow to
the brain, and McCullough said women have "unique risk
Among them are the use of birth control pills and hormone
replacement therapy after menopause, which both increase stroke
risk. Pregnancy-associated disorders also may have long-lasting
effects on a woman's health and her stroke risk, she added.
Here's why all that is important: An estimated 6.8 million
persons in the United States have had a stroke, 3.8 million of whom
are women, according to the summary. Women have poorer recovery and
worse quality of life than men after a stroke, the summary
And here's what women can expect if their primary care doctor
adheres to the new guidelines.
Your doctor will screen for high blood pressure. It is the most
changeable risk factor, and it's more common in women than in
Depending on your age, your doctor may screen for atrial
fibrillation, an abnormal heart rhythm, by measuring pulse rate and
doing an electrocardiogram.
Your doctor may ask you about any history of headaches. Migraine
headache with aura can increase stroke risk, and McCullough said
reducing the frequency of migraine should be the goal as a possible
way to reduce stroke risk.
Certain pregnancy-related conditions affect risk, McCullough
said. "If you have pregnancy-induced high blood pressure, you are
fourfold more likely to develop high blood pressure in adulthood
and two times more likely to have a stroke," she said. Keeping
blood pressure under control is crucial.
Stroke during pregnancy is not common, but experts have found
the risk is highest in the 12 weeks after giving birth. So women
who have a new headache, blurred vision or other unusual symptoms
should be checked out.
Depression and emotional stress also boost stroke risk,
McCullough said, so your doctor should ask about that, too.
The guidelines also recommend focusing on a healthy lifestyle
that helps prevent stroke. These measures include keeping weight at
a healthy level, eating a healthy diet, not smoking, getting
regular physical activity and keeping alcohol intake moderate, if
"This article is going to be very helpful in getting the message out to the primary care physicians," said Dr. Ravi Dave, director of interventional cardiology at the University of California Los Angeles Medical Center in Santa Monica.
He noted that some of the risk factors for stroke may be news to
women, such as the link between depression and stroke. "I would
encourage these patients with depression to get treated for it," he
In recent years, Dave said, researchers have been pinpointing
differences in heart attack symptoms between men and women. Now,
the same thing is happening with risk factors for strokes, teasing
out the gender differences. For women, the message is clear, he
said: Alert your doctor if you have any of these stroke risk
factors, or suspect you do.
Learn more about the new guidelines for reducing stroke risk in
women at the
American Heart Association.
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