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
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
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
Other risk factors more common in women than men include migraine
with aura, atrial fibrillation, diabetes, depression and emotional
These are signs 52-year-old Karen Rastenis from Solon, Ohio, wished
she had been aware of a while back. Before her stroke two years ago,
Rastenis was a smoker and more than 150 lbs overweight. When she
woke up one morning with weakness on her right side, the busy single
mother of two teenagers ignored the symptom. Then it kept getting
By the time she went to the hospital a few
days later, her blood pressure was dangerously high at 237 over 160.
She had already had a stroke in her brain stem and "I was on the
verge of having a massive stoke," she said.
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Rastenis says she had always been overweight but she did not know
she had high blood pressure before the stroke.
Still, there had been warning signs. She had had migraines with aura
from the start of puberty until she had her first child. During that
pregnancy, she also had preeclampsia.
Since her stroke, Rastenis has taken several steps to prevent
another. She has quit smoking and had weight loss surgery. She has
already lost 60 lbs.
Still, she wishes she had known about the risks earlier.
"It's about time that they looked at the differences in stroke
between males and females," she said. "We've known that a woman's
heart attack will present differently than a man's. It seems to
follow that the same is true of stroke."
Dr Shazam Hussain, stroke section head at the Cleveland Clinic in
Ohio, who was not involved in the study, said the guidelines were
"Certainly, there is something in common between men and women in
terms of stroke risk factors. It's also been recognized there are
differences," he said, noting that women tend to do worse after a
stroke and are also more likely to die from stroke than men.
"I think recognizing that, putting that on the table as a group that
needs more focus when we do studies and when we care for women is
very important," he said.
(Reporting by Julie Steenhuysen; editing
by Gunna Dickson)
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