Prevention of Stroke In Women

Publication Date: February 6, 2014

Key Points

Key Points

In the United States, more than half (53.5%) of the estimated 795,000 new or recurrent strokes occur among women annually, resulting in ≈55,000 more stroke events in women than men.

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

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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...

Prevention of Preeclamps...

...n with chronic primary or secondary hyperte...

...lcium supplementation (of ≥1 g/d, orally...


...pertension in Pregnancy and Postpartum...

...hypertension in pregnancy should be t...

...ion may be given to treatment of moderat...

...olol, angiotensin receptor blocker...

...r giving birth, women with chronic hypertens...


...vention of Stroke in Women With a History of...

...cause of the increased risk of future hyperten...


...l Venous Thrombosis (CVT)...

...ith suspected CVT, routine blood stu...

...ening for potential prothrombotic con...

...othrombotic conditions, including protein...

...with provoked CVT (associated with a t...

...ts with unprovoked CVT, vitamin K an...

...nts with recurrent CVT, VTE after CVT,...

...CVT during pregnancy, LMWH in full...

...t is reasonable to advise women with a history...

...nable to treat acute CVT during preg...

...a history of CVT, prophylaxis with...


...traceptives (OCs)...

...e harmful in women with additional risk factor...

...aggressive therapy for stroke risk factors...

...ning for prothrombotic mutations be...

...P before initiation of hormonal contraception i...


...ostmenopausal...

...or without medroxyprogesterone) should N...

...ogen receptor modulators, such as raloxifene,...


...aine With Aura...

Because there is an association between higher...

Because of the increased stroke risk see...


...olic Syndrome, and Lifestyle Factors...

...estyle consisting of regular physical activity, m...

...interventions focusing on diet and exercis...


...al Fibrillation (AF)...

...tification tools in AF that account fo...

...the increased prevalence of AF with a...

...anticoagulation in women aged ≤65 years w...

...Antiplatelet therapy is a reasonabl...

...gulants are a useful alternative to warfarin for t...


Strategies for Prevention of Stroke i...

...th asymptomatic carotid stenosis should be screen...

...en who are to undergo CEA, aspirin is recommende...

Prophylactic CEA performed with

...women with recent TIA or IS within th...

For women with recent transient ischemic attac...

...hen CEA is indicated for women with TIA or...

...pirin therapy (75-325 mg/d) is reasonable in...

If a high-risk (ie, 10-year predicted CVD r...

...ontrolled and the benefit for IS and MI preventio...

and may be reasonable for wom...


...le 2. Summary of Antihypertensive Drugs...

...egory Maternal Side Effects...

...ng α2-adrenergic agonist (eg, methyldopa) Sedat...

...(thiazide) Hypokalemia No ( B , )7...

...atenolol) Headache Associated with fe...

...ers (pindolol, metoprolol) Headache Possible feta...

...ium channel blockers (eg, nifedipine) Headache;...

...ed a-β blockers (labetalol) May provoke...

...flex tachycardia, delayed hypotension Neonatal t...

..., angiotensin receptor blockers, renin inhibitors...