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Stroke Guidelines for Women

Stroke Guidelines for Women

Both men and women share many of the same high-risk predictors for stroke, such as smoking, family history, and physical inactivity. However, some risk factors are either exclusive to women or affect women disproportionately. The American Heart Association (AHA) and American Stroke Association (ASA) recently convened a panel of experts in neurology, obstetrics, cardiology, epidemiology, and internal medicine to review and assess the literature on stroke risk in adults. This resulted in the publishing of the first gender-specific AHA/ASA guidelines for stroke prevention in women. “The development of these guidelines is important because women differ from men in many ways with regard to stroke,” explains Cheryl B. Bushnell, MD, who chaired the AHA/ASA writing group that developed the document. Several characteristics can influence stroke risk and impact outcomes, including genetic differences in immunity, coagulation, hormonal factors, reproductive factors (eg, pregnancy and childbirth), and social factors. “Many of the unique risk factors for women present at younger ages due to things like oral contraceptive use and pregnancy complications,” Dr. Bushnell explains. “Recognition of stroke risk and identification of prevention strategies could start early in at-risk women.” Highlighting Key Recommendations Based on available evidence, the AHA/ASA guidelines categorized risk factors by those that were sex-specific, more prevalent in women, or similar between women and men (Table 1). Dr. Bushnell says it is critical to recognize that women with a history of hypertension or preeclampsia during pregnancy are at risk for stroke and hypertension later in life. “Before this guideline emerged, few providers and women knew about this risk,” she says. “The evidence for this relationship is strong, and multiple meta-analyses have...
Assessing Women’s Knowledge of Stroke Warning Signs

Assessing Women’s Knowledge of Stroke Warning Signs

According to national estimates, stroke is the third leading cause of death among women in the United States, and the aftermath of these events is significant among survivors. Studies have found that about one-third of women who survive a stroke will need help caring for themselves, whereas 16% will require institutional care, and 7% will have an impaired ability to work. Each year, about 55,000 more women than men will have a stroke. There has also been a rise in stroke prevalence among middle-aged women that has not been seen in their male counterparts, highlighting the need for a better understanding of stroke among women of all ages. Research has shown that women from racial and ethnic minority backgrounds experience a disproportionate stroke burden. For example, African-American women have an incidental stroke risk that is almost twice as high as that of Caucasian women. Some studies indicate that the prevalence of stroke risk factors may be higher among Hispanic women. “Considering these risks, it’s important to assess the ability of women to recognize stroke warning signs at their onset,” says Heidi Mochari-Greenberger, PhD, MPH. “Early recognition may lead to more rapid access to emergency care, which in turn may result in decreased stroke-related morbidity and mortality.”   Surveying the Scene To improve outcomes and reduce disparities, it is important to address gaps in women’s knowledge as it relates to stroke warning signs. In 2012, the American Heart Association (AHA) commissioned a national survey to determine women’s cardiovascular disease awareness. This survey also included an assessment of knowledge relating to stroke warning signs. For a study published in Stroke, Dr....
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