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New Guidelines Aim to Reduce Women's Stroke Risk

Older women stroke risk

Older women have a higher risk of stroke than men and should strive to reduce that risk, say the first guidelines aimed specifically at preventing stroke in women.

Women share many of the same risk factors for stroke with men, but their chances of having a stroke can be increased by hormones, pregnancy and childbirth, said Cheryl Bushnell, M.D., associate professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, N.C., who led the team of experts who developed the guidelines.

Women are also more likely than men to have high blood pressure, migraine with aura, atrial fibrillation,  diabetes, depression and emotional stress, all of which also increase their stroke risk, according to the new  guidelines published  in the journal Stroke. Women tend to live longer than men, which helps explain why the risk of stroke in women ages 55 to 75 is higher in women than men.

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Previous heart disease guidelines included information about preventing stroke in women, but the advice was buried within all the other recommendations, Bushnell told the Washington Post. "We wanted to take topics that are really women-specific and emphasize stroke and put it all in one guideline," she said. Stroke is the third leading cause of death for women, who make up more than half of the 800,000 people in the United States who have a stroke each year, notes the American Heart Association (AHA). Even though women often have the same stroke symptoms as men, they may be more subtle, Bushnell pointed out to the Post. Plus, women are more likely than men to have difficulty speaking  or communicating after a stroke.

To lessen their risk, women need to pay close attention to their blood pressure and have it treated if it's high, Bushnell said. Other ways to reduce risk, per the new guidelines: Exercise regularly, don't drink too much alcohol, don't smoke, and eat a diet rich in fruits, vegetables, grains and olive oil and low in saturated fat (sound familiar?).

Among specific new guidelines that affect women over 50:

  • Women who have migraine headaches with aura should stop smoking to avoid a higher risk of stroke.
  • Women 75 or older should be screened for atrial fibrillation - an irregular heart rhythm - risk because of its link to a higher risk for stroke.


Stroke symptoms and warning signs

Women often fare worse than men when they have a stroke, so it's important to know the symptoms. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts, according to the AHA. When part of the brain is cut off from the blood, and thus the nutrients and oxygen, it needs, brain cells die.  Stroke symptoms - such as weakness or numbness on one side of the body or difficulty talking - often develop suddenly and without warning. Sometimes they  occur on and off over a day or two.

Because the best window of  treatment is about three hours from the start of symptoms, it's crucial to call 911 immediately if you suspect you or someone else is having a stroke. The longer the blood flow is cut off to the brain, the worse the damage. There are three types of stroke. Most strokes are ischemic, which means they happen when a blood clot blocks a blood vessel in the brain or an artery. If administered quickly, clot-busting drugs can greatly reduce the damage of this type of stroke.

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A second type of stroke, hemorrhagic, occurs when a blood vessel in the brain breaks, causing bleeding in the brain. These strokes may require surgery. A third type of stroke is a transient ischemic attack (TIA); a TIA happens when blood to the brain is disrupted temporarily. Although symptoms may last for only an hour or so and go away, these ministrokes are often a warning sign that a major stroke could be on the way. If you have a TIA, you should always call your doctor or go to an emergency clinic right away.

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