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
...tion of Preeclampsia...
...onic primary or secondary hypertensi...
...upplementation (of ≥1 g/d, orally) s...
...atment of Hypertension in Pregnancy and Po...
Severe hypertension in pregnancy should be treated...
...may be given to treatment of moderate...
...otensin receptor blockers, and direct renin...
After giving birth, women with chronic h...
...evention of Stroke in Women With a H...
...increased risk of future hypertension and st...
...rebral Venous Thrombosis...
...with suspected CVT, routine blood studies c...
...r potential prothrombotic conditions that may p...
...rothrombotic conditions, including protein C,...
...ts with provoked CVT (associated with a t...
...ts with unprovoked CVT, vitamin K antagonists...
...th recurrent CVT, VTE after CVT, or fir...
...n with CVT during pregnancy, LMWH i...
...t is reasonable to advise women with a hi...
...is reasonable to treat acute CVT dur...
...n with a history of CVT, prophylaxis...
...ral Contraceptives (O...
...Cs may be harmful in women with additional risk fa...
...sers, aggressive therapy for stroke ri...
...ening for prothrombotic mutations bef...
...f BP before initiation of hormonal contracep...
...ostmenopausal...
...h or without medroxyprogesterone)...
...strogen receptor modulators, such as raloxi...
...igraine With A...
...here is an association between higher migrain...
...of the increased stroke risk seen in women with m...
...ity, Metabolic Syndrome, and Lifestyle Factor...
...yle consisting of regular physical acti...
...interventions focusing on diet and...
...l Fibrillation (AF)...
...tratification tools in AF that acc...
...ering the increased prevalence of AF with ag...
...icoagulation in women aged ≤65 years...
Antiplatelet therapy is a reasonable therap...
...coagulants are a useful alternative to warf...
...s for Prevention of Stroke in Women...
...th asymptomatic carotid stenosis should be sc...
...women who are to undergo CEA, aspirin is recomme...
...actic CEA performed wi...
...or women with recent TIA or IS within the past 6...
...ecent transient ischemic attack (TIA) or is...
...en CEA is indicated for women with TIA or s...
...spirin therapy (75-325 mg/d) is reasonable in wo...
...high-risk (ie, 10-year predicted CVD risk...
...is controlled and the benefit for IS and MI...
...may be reasonable for women
.... Summary of Antihypertensive Drugs Used Dur...
...Category Maternal Side Ef...
...cting α2-adrenergic agonist (eg, m...
...zide) Hypokalemia No ( B , )701...
...rs (atenolol) Headache Associated...
...s (pindolol, metoprolol) Headache Possible f...
...el blockers (eg, nifedipine) Headache; possi...
...blockers (labetalol) May provoke asthma exacerba...
...eflex tachycardia, delayed hypotension Neo...
...angiotensin receptor blockers, renin inh...