First-Ever Guidelines Issued on Stroke Prevention in Women

By Amy Orciari Herman

The American Heart Association and American Stroke Association have issued the first stroke-prevention guidelines that focus on women's unique risks.

Among the recommendations:

-- Pregnant women with chronic hypertension or a history of pregnancy-related hypertension should take low-dose aspirin, beginning at 12 weeks' gestation, to reduce preeclampsia risk.

-- Preeclampsia is a risk factor for stroke later in life, and other risk factors in such women should be treated early.

-- Pregnant women with severe hypertension should receive antihypertensive therapy (e.g., methyldopa, labetalol); those with moderate hypertension (150-159 mm Hg/100-109 mm Hg) may be considered for treatment.

-- Suspicion of cerebral venous thrombosis, more common in women, should warrant routine blood studies: complete blood count, chemistry panel, prothrombin time, and activated partial thromboplastin time.

Hooman Kamel, a neurologist with NEJM Journal Watch, notes that "to be effective, many of these recommendations will require diffusion into routine primary care practice."