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Ask Dr. K: Guidelines for women to prevent stroke

Anthony L. Komaroff Universal Uclick

DEAR DOCTOR K: Do women need to take special precautions to prevent a stroke?

DEAR READER: Yes, they do – and a new set of guidelines published earlier this year helps us to understand what those steps should be. The guidelines discuss stroke risk factors that women should consider from adolescence to old age.

The first thing that may be surprising about the guidelines is that they include stroke prevention advice for young women.

Take, for example, young women who are thinking about going on the birth control pill. Oral contraceptives boost the risk of stroke, even in younger women.

The risk of oral contraceptives causing a stroke starts to increase when women reach age 35.

In women over age 35 who also smoke, the risk of stroke increases considerably. I advise such women to avoid using estrogen-containing pills, patches or devices.

The guidelines note that about one in 12 women develops pre-eclampsia or other blood pressure problems during pregnancy. Untreated pre-eclampsia can lead to strokes. The guidelines recommend that women who have had pre-eclampsia, or are at risk for developing it, take low-dose aspirin until delivery.

Pre-eclampsia disappears after delivery. But women who develop it are more likely to develop high blood pressure later in life, which then puts them at risk for stroke if not properly diagnosed and treated.

Atrial fibrillation is a fast and irregular heartbeat. It is also a leading cause of stroke, more so in women than in men. Women with this condition should take a blood-thinning drug to help prevent stroke.

The guidelines also recommend that women ages 65 to 79 talk with their doctor about taking a daily baby aspirin (81 milligrams) to reduce the risk of stroke.

So even though strokes can occur in women of all ages, we now know how to reduce the risks considerably.

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