New Guidelines for Women: Migraines, Pregnancy Complications Boost Risk of Stroke

Madison, Wisconsin - The mere fact of being female can raise the risk of stroke, with hormones, pregnancy and severe migraines all adding to the picture.


Women-specific guidelines released last month by the American Heart Association/American Stroke Association (AHA/ASA) highlight the unique stroke risks women face. They warn that blood pressure problems during pregnancy, such as preeclampsia, may herald stroke risk 30 years later.


"Some of these risks were known before, but this is the first time they've been pulled together in one place," says Chris Whelley, a master's-trained nurse who coordinates the UW Comprehensive Stroke Center. "Women should be aware of the risk factors and talk with their doctors about them."


Stroke is the fourth-leading killer of American women and women suffer more strokes and more disabling strokes than men. They're also much more likely to suffer a rare type of stroke, a cerebral venous thrombosis, which occurs when a clot blocks a vein draining the brain, leading to a severe headache. Women make up more than 70 percent of the cases of this type of stroke, a difference attributed to the hormones of pregnancy and birth control pills.


A stroke generally occurs when blood to the brain is blocked by a clot or leaks out through a blood vessel rupture. Warning signs include drooping face, numbness or weakness in the arms and speech difficulty. Women are more likely to have difficulty communicating.


Some of the new AHA/ASA guidelines say that women should:

  • Tell their doctors if they developed pre-eclampsia, a dangerous rise in blood pressure while pregnant. Women who had pre-eclampsia during pregnancy have twice as high a risk of stroke later in life.
  • Quit smoking, especially if they've had visual migraines that include flashing lights or blinking dots. Women are four times more likely to have migraines than men, and these complex migraines increase future stroke risk.
  • Be screened for high blood pressure before going on oral contraceptives.
  • Take blood-pressure medication during pregnancy if they develop moderately high blood pressure, defined as 150 to 159 over 100 to 109 millimeters of mercury.
  • Be screened for atrial fibrillation at age 75 and older.
  • Take positive steps for health, such as exercising, moderating alcohol use, quitting smoking, and eating a diet rich in fruits, vegetables, grains, nuts and olive oil.

"We need to do a better job reaching out to women and helping them achieve these lifestyle changes," Whelley says. "Because women tend to suffer stroke at an older age, when they're more likely to be living alone, the results can be much more devastating."

Date Published: 03/04/2014

News RSS Feed