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
...eatment...
...ntion of Preeclampsia...
...ic primary or secondary hypertension or p...
...plementation (of ≥1 g/d, orally)...
...of Hypertension in Pregnancy and Postpartum...
...hypertension in pregnancy should be treated wi...
...ay be given to treatment of moderate hyperten...
...nolol, angiotensin receptor blockers, a...
...g birth, women with chronic hypertension sh...
...roke in Women With a History of Preeclampsi...
Because of the increased risk of future hypertens...
...l Venous Thrombosis (CVT)
...ts with suspected CVT, routine blood st...
...ing for potential prothrombotic condition...
...esting for prothrombotic conditions, including pr...
...with provoked CVT (associated with a...
...s with unprovoked CVT, vitamin K antagonis...
...or patients with recurrent CVT, VTE after CVT, or...
...ith CVT during pregnancy, LMWH in f...
...reasonable to advise women with a histo...
...able to treat acute CVT during pregnancy with full...
...n with a history of CVT, prophylaxis...
...ntraceptives (OCs)...
...ay be harmful in women with additional...
...sers, aggressive therapy for stroke...
...screening for prothrombotic mutatio...
...ent of BP before initiation of hormonal contra...
...enopausal HT
...th or without medroxyprogesterone)...
...en receptor modulators, such as ralox...
...igraine With Aura
...se there is an association between higher mi...
...he increased stroke risk seen in women...
...y, Metabolic Syndrome, and Lifestyle Factors...
A healthy lifestyle consisting of re...
...terventions focusing on diet and exercise are reco...
...ial Fibrillation...
...isk stratification tools in AF that account for ag...
Considering the increased prevalence of AF wi...
...Oral anticoagulation in women aged ≤65 years wit...
...Antiplatelet therapy is a reasonable t...
...w oral anticoagulants are a useful alternative to...
...for Prevention of Stroke in Women...
...omen with asymptomatic carotid stenosis...
...are to undergo CEA, aspirin is recomme...
...ylactic CEA performed with...
...th recent TIA or IS within the pas...
...men with recent transient ischemic attack (TIA) or...
...hen CEA is indicated for women with TIA or...
...therapy (75-325 mg/d) is reasonable in w...
...h-risk (ie, 10-year predicted CVD risk...
...f BP is controlled and the benefit for IS and MI p...
...y be reasonable for wome...
...ble 2. Summary of Antihypertensive Drugs Used...
...gory Maternal Side Effects Ter...
...ting α2-adrenergic agonist (eg, methyl...
...iazide) Hypokalemia No ( B , )701...
...tenolol) Headache Associated with fetal gr...
...ers (pindolol, metoprolol) Headache Possible f...
...blockers (eg, nifedipine) Headache; pos...
...β blockers (labetalol) May provoke ast...
...eflex tachycardia, delayed hypotension Neon...
...tors, angiotensin receptor blockers...