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
...atment
...evention of Preecl...
...men with chronic primary or secondary hypertensio...
...um supplementation (of ≥1 g/d, orally) s...
...of Hypertension in Pregnancy and Postpartum...
...vere hypertension in pregnancy should be treated...
...n may be given to treatment of moderate hyperte...
..., angiotensin receptor blockers, and direct...
...ter giving birth, women with chronic hy...
...troke in Women With a History of Pre...
...of the increased risk of future hyperten...
...enous Thrombosis (CVT)
...n patients with suspected CVT, routine b...
Screening for potential prothrombotic conditio...
...ing for prothrombotic conditions, including pr...
...s with provoked CVT (associated with a transien...
...patients with unprovoked CVT, vitamin K antagon...
...ith recurrent CVT, VTE after CVT, or first CV...
...with CVT during pregnancy, LMWH in full a...
...le to advise women with a history...
...s reasonable to treat acute CVT during pre...
...women with a history of CVT, proph...
...traceptives (OCs)...
...may be harmful in women with additional ri...
...users, aggressive therapy for stroke risk...
...ening for prothrombotic mutations before initiat...
...P before initiation of hormonal contraception is r...
...stmenopausal HT
...with or without medroxyprogesterone) should...
...e estrogen receptor modulators, such as ralox...
...graine With...
...e is an association between higher mig...
...the increased stroke risk seen in women w...
Obesity, Metabolic Syndrome, and Lifest...
...healthy lifestyle consisting of regul...
...ifestyle interventions focusing on diet and...
...ibrillation (AF)...
...tratification tools in AF that acco...
...dering the increased prevalence of AF wit...
...gulation in women aged ≤65 years...
...let therapy is a reasonable therapeutic option for...
...agulants are a useful alternative to warfarin...
...gies for Prevention of Stroke in...
...en with asymptomatic carotid stenosis should be sc...
...who are to undergo CEA, aspirin is recommende...
...ic CEA performed with...
...r women with recent TIA or IS withi...
...ith recent transient ischemic attack (T...
...hen CEA is indicated for women with TIA...
...apy (75-325 mg/d) is reasonable in...
...sk (ie, 10-year predicted CVD risk ≥10%)...
...ontrolled and the benefit for IS and MI preventi...
...d may be reasonable for women...
...2. Summary of Antihypertensive Drugs Used Durin...
...egory Maternal Side Effects Terato...
...α2-adrenergic agonist (eg, methyldopa)...
...retics (thiazide) Hypokalemia No ( B...
...enolol) Headache Associated with fetal growt...
...lockers (pindolol, metoprolol) Headache Pos...
...alcium channel blockers (eg, nifedipine) Head...
...blockers (labetalol) May provoke asthma ex...
...ne Reflex tachycardia, delayed hypotension Neona...
...inhibitors, angiotensin receptor blo...