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
...Treatment...
...Preventio...
...nic primary or secondary hypertension or previou...
...lcium supplementation (of ≥1 g/d, or...
...Treatment of H...
...tension in pregnancy should be tre...
...sideration may be given to treatmen...
...giotensin receptor blockers, and direct...
...giving birth, women with chronic hypertens...
...Prevention of Stro...
...increased risk of future hypertension and str...
...Cerebral V...
...tients with suspected CVT, routine blood stud...
...tential prothrombotic conditions th...
...prothrombotic conditions, including pro...
...s with provoked CVT (associated wit...
...ients with unprovoked CVT, vitamin K antagonists...
...with recurrent CVT, VTE after CVT, or f...
...CVT during pregnancy, LMWH in full anticoagulant...
...s reasonable to advise women with a...
...reasonable to treat acute CVT during pregnan...
...omen with a history of CVT, prophylaxis w...
...Oral Contracept...
...may be harmful in women with additional ris...
...sers, aggressive therapy for stroke r...
Routine screening for prothrombotic mu...
...ent of BP before initiation of hormonal...
...Postmenop...
...r without medroxyprogesterone) should NOT be u...
...rogen receptor modulators, such as raloxifene,...
...Mig...
...ecause there is an association betwe...
Because of the increased stroke risk seen i...
...Obes...
...healthy lifestyle consisting of regular physic...
...estyle interventions focusing on diet an...
...Atrial Fibr...
...ratification tools in AF that account...
...sidering the increased prevalence...
...anticoagulation in women aged ≤65...
...et therapy is a reasonable therapeutic option for...
...gulants are a useful alternative to warfarin for...
...Stra...
...with asymptomatic carotid stenosis shou...
...are to undergo CEA, aspirin is recommend...
...lactic CEA performed wit...
...or women with recent TIA or IS within the past 6...
...recent transient ischemic attack (TIA) or i...
...is indicated for women with TIA or stroke, surg...
...rin therapy (75-325 mg/d) is reasonable in women...
...high-risk (ie, 10-year predicted C...
...P is controlled and the benefit for IS and MI...
...d may be reasonable for women...
...Table...
...egory Maternal Side Effects Te...
...ly acting α2-adrenergic agonist (eg, m...
...(thiazide) Hypokalemia No ( B , )701...
β-Blockers (atenolol) Headache Associated with...
...ockers (pindolol, metoprolol) Head...
...lcium channel blockers (eg, nifedipine...
...blockers (labetalol) May provoke asthma exacerba...
...Reflex tachycardia, delayed hypot...
...inhibitors, angiotensin receptor bl...