First Stroke Prevention Guidelines Issued for Women

YSPH researcher contributes to document issued by American Heart Association/American Stroke Association

Men are from Mars, women are from Venus. This is as true for the nature of stroke as it is for attitudes toward relationships. Yet, there has never before been a guideline dedicated to stroke risk and prevention in women.

The new 86 page document, issued today by the American Heart Association/American Stroke Association addresses four risk factors distinct to women, such as pregnancy, oral contraceptives, menopause and hormone replacement, as well as four factors that affect women disproportionately such as atrial fibrillation and migraine with aura.

The guidelines, for instance, include specific recommendations for low-dose aspirin and calcium regimens for pregnant women with hypertension.

The guidelines are mapped out so that clinicians and researchers can examine risk factor during different periods of a women’s lifecycle from pre-pregnancy, to pregnancy, to menopause and beyond. 

“We reviewed a large body of research to be able to summarize our current understanding of stroke risk and stroke prevention in women, information that is critically important for care providers and researchers in the field.,” said Judith Lichtman, Ph.D., associate professor at the Yale School of Public Health and co-author of the study. “The guidelines are also important to empower women and their families to better understand their risk for stroke and be aware of ways they can minimize their likelihood of having a one.”   Lichtman is also a researcher at the Center for Outcomes Research and Evaluation at the Yale School of Medicine. She was one 17 interdisciplinary experts from around the country to contribute to the guidelines.

Strokes are the third leading cause of death among women and 55,000 more stroke events occur in woman annually then annually. By 2030, 19 percent of the population will be over age 65 and women will increasingly outnumber men, making the volume of incidents among women even more significant.Nearly half of stroke survivors remain disabled six months after an attack, posing a serious quality of life issue for elderly women living alone.

“There has not been adequate recognition of the real burden of stroke on women. Studies show that women have worse outcomes than men, and that needed be to addressed,” says Lichtman.  Aspects of female physiology, sexual and hormonal differences have not been addressed in general guidelines for the population. “Our extensive review of the literature identified a number of unique sex-specific risk factors for women, yet there are currently no risk prediction models that include these factors. Additional research is needed to develop and validate appropriate stroke risk scores, as well as tailor stroke prevention strategies specifically for women.”

Lichtman collaborated with researchers in cardiology and neurology from around the country. The guidelines are published online in the journal Stroke.

This article was submitted by Denise L Meyer on February 6, 2014.