Did you know that it’s not just older men having strokes anymore? Strokes are debilitating, life-threatening events that are often associated with aging men, but the new reality is that women are more likely than men to have a stroke. And women of all ages are at risk. Being pregnant and having preeclampsia both increase a woman’s risk of stroke and the preeclampsia-related risk lingers on, as long as 40 years after the pregnancy.

New Recommendations for Women

According to the American Stroke Association and the American Heart Association, strokes are the #4 cause of death in men and women in the United States and the #1 cause of disability. Only heart disease and cancer kill more American women. These two highly respected medical associations have just co-published their first-ever stroke prevention guidelines specifically for women. The recommendations are officially affirmed by the American Academy of Neurology and endorsed by the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

What is a Stroke?

Strokes occur when a blood vessel in the brain ruptures or when the blood supply to the brain is interrupted for various reasons, including clots and irregular heart rhythm. A stroke always produces brain damage and surviving women typically experience a poorer quality of life after a stroke than men do.

Stroke Symptoms

Symptoms can be the same in men and women but they may seem milder, less severe, in women. Women also have a tendency to overlook their own warning signs of stroke, downplaying the significance of what the body is telling them. Take it seriously if you notice:

• Facial drooping
• Sudden weakness or numbness in an arm
• Difficulty speaking
• Problems understanding what others are saying

Stroke Prevention

Recommendations for preventing stroke include:

• Moderate but regular physical activity.
• Moderate consumption of alcohol.
• Avoid smoking completely.
• Eat lots of fruits, veggies, whole grains, and raw nuts.
• Cook with olive oil; avoid saturated fats (butter, margarine, shortening, lard, cheeses, fatty meats, etc.).
• Avoid the salt shaker and salty foods.
• Make sure blood pressure is checked before taking birth control pills.
• Monitor blood pressure while taking birth control pills.
• If you had high blood pressure before pregnancy, ask your doctor about taking low-dose aspirin, calcium supplements, or both to minimize the risk of preeclampsia.

Preeclampsia and Eclampsia
Preeclampsia is a pregnancy-related form of high blood pressure that also produces high levels of protein in the urine. It can cause major complications of pregnancy, including premature birth, stroke during and after delivery, and increased risk of stroke as long as 40 years after the original diagnosis. When preeclampsia progresses to eclampsia, seizures can occur.

Increased Risk Factors
Other factors that increase a woman’s risk of stroke include depression, diabetes, and atrial fibrillation (abnormal heart rhythm). Migraines with aura increase the risk of stroke; smoking and migraines compound the risk dramatically. It is exceptionally important to discuss these conditions with your obstetrician if you are pregnant or want to become so.

Pregnancy and Blood Pressure Medication
Lifestyle alterations can effectively reduce risk in many cases but blood pressure medications may be needed, too. There is controversy regarding the safety of blood pressure medications taken during pregnancy so be sure to discuss the matter with your obstetrician. Each patient must be evaluated and treated on an individual basis.


Source: “AHA/ASA Guideline: Guidelines for the Prevention of Stroke in Women.” American Heart Association and American Stroke Association. BushnellManuscript. Feb 6, 2014. Web. Feb 13, 2014.