Prevention of Stroke In Women
Key Points
Key Points
Most (87%) strokes are ischemic (IS), with the remainder hemorrhagic (10% intracerebral [ICH] and 3% subarachnoid [SAH]).
Table 1. Stroke Risk Factors, Categorized by Those That Are Sex-Specific, Stronger or More Prevalent in Women, or Similar Between Women and Men
| Risk Factor | Sex-Specific | Stronger or More Prevalent in Women | Similar Prevalence in Men and Women but Unknown Difference in Impact |
|---|---|---|---|
| Pregnancy | X | ||
| Preeclampsia | X | ||
| Gestational diabetes | X | ||
| Oral contraceptive use | X | ||
| Postmenopausal hormone use | X | ||
| Changes in hormonal status | X | ||
| Migraine with aura | X | ||
| Atrial fibrillation | X | ||
| Diabetes mellitus | X | ||
| Hypertension | X | ||
| Physical inactivity | X | ||
| Age | X | ||
| Prior cardiovascular disease | X | ||
| Obesity | X | ||
| Diet | X | ||
| Smoking | X | ||
| Metabolic syndrome | X | ||
| Depression | X | ||
| Psychosocial stress | X |
Figure 1. US stroke mortality rates for women, 2009a
Figure 2. Female-male US stroke mortality ratio, 2009a
Treatment
...reatment
...ntion of Preeclampsia...
...with chronic primary or secondary h...
...lcium supplementation (of ≥1 g/d, or...
...of Hypertension in Pregnancy and Postp...
...hypertension in pregnancy should be treated with s...
...deration may be given to treatment of moderate hy...
...l, angiotensin receptor blockers, and direc...
...er giving birth, women with chronic hypertension...
Prevention of Stroke in Women With a Hist...
...e of the increased risk of future h...
...Venous Thrombosis (CVT)...
...tients with suspected CVT, routine bl...
...for potential prothrombotic condi...
...prothrombotic conditions, including protein C, p...
...ith provoked CVT (associated with a transient...
...nts with unprovoked CVT, vitamin K antago...
...ents with recurrent CVT, VTE after CVT, o...
...n with CVT during pregnancy, LMWH in full anticoag...
...sonable to advise women with a history of CVT...
...reasonable to treat acute CVT during...
...a history of CVT, prophylaxis with LMW...
...l Contraceptives (OCs...
...be harmful in women with additional risk factors...
...C users, aggressive therapy for stroke risk fac...
...tine screening for prothrombotic mutations before...
...of BP before initiation of hormonal...
...ostmenopausal HT
...(CEE with or without medroxyprogesteron...
...gen receptor modulators, such as raloxifene,...
...aine With Aura...
...e there is an association between higher...
...increased stroke risk seen in wom...
...Metabolic Syndrome, and Lifestyle Fa...
...hy lifestyle consisting of regular physical ac...
...tyle interventions focusing on diet and exercis...
...ibrillation (AF)...
...stratification tools in AF that acc...
...ering the increased prevalence of AF with ag...
...ral anticoagulation in women aged ≤65...
...platelet therapy is a reasonable therapeuti...
...oral anticoagulants are a useful alte...
Strategies for Prevention of Stroke in Wo...
...tomatic carotid stenosis should be...
...n who are to undergo CEA, aspirin is...
...ctic CEA performed with...
...en with recent TIA or IS within the p...
...ith recent transient ischemic attack (TIA) or is...
...indicated for women with TIA or stroke, s...
...rin therapy (75-325 mg/d) is reasonab...
If a high-risk (ie, 10-year predicted...
...f BP is controlled and the benefit for IS and MI...
...be reasonable for women...
...mary of Antihypertensive Drugs Used Durin...
...Category Maternal Side Ef...
...y acting α2-adrenergic agonist (eg, methyldopa...
...etics (thiazide) Hypokalemia No ( B , )701...
...ockers (atenolol) Headache Associated with fetal...
...(pindolol, metoprolol) Headache Pos...
...l blockers (eg, nifedipine) Headache; possible in...
...lockers (labetalol) May provoke asthma exacerbatio...
...azine Reflex tachycardia, delayed hypo...
...itors, angiotensin receptor blockers, renin i...