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Bushnell Leads Introduction of Guidelines to Prevent Stroke in Women
For the first time, guidelines have been developed for the American Heart Association (AHA) on preventing stroke in women, and a Wake Forest Baptist faculty member led the project.

Cheryl Bushnell, MD, associate professor of neurology and director of the Stroke Center at Wake Forest Baptist, was the lead author of the new scientific statement published in February in the AHA journal Stroke.

“If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” Bushnell said.

Stroke is the third leading cause of death for American women, after heart disease and cancer. The scientifically based recommendations on how best to treat stroke in women include:

  • Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks.
  • Women who have preeclampsia have twice the risk of stroke and a fourfold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol and obesity in these women should be treated early.
  • Pregnant women with moderately high blood pressure (150–159/100–109 mmHg) may be considered for blood pressure medication, whereas expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
  • Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.
  • Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
  • Women over age 75 should be screened for atrial fibrillation risks due to its link to higher stroke risk.

logoThe guidelines garnered widespread attention from media outlets, including The New York Times, Washington Post, CBS News and
the BBC.

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