Women of all ages should pay more attention to the risk of stroke than the average man, watching their blood pressure carefully even before they think about taking birth control pills or getting pregnant, according to a new set of guidelines released Thursday.
Women are also more likely to have risk factors associated with stroke, such as migraines, depression, diabetes and abnormal heart rhythm known as atrial fibrillation.
The new guidelines were issued by the American Heart Association.
Stroke is the fourth-leading cause of death for all Americans but the third-leading cause of death for women after heart disease and cancer.
Women share many of the same risk factors as men for stroke, but they also have unique risks that come with pregnancy complications and hormone use, said Cheryl Bushnell, associate professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, N.C., who led a group of experts that developed the guidelines.
Previous guidelines about cardiovascular prevention in women have included some information about stroke. "But it was buried in there," said Bushnell, who has been studying the topic for more than a decade. "We wanted to take topics that are really women-specific and emphasize stroke and put it all in one guideline."
The recommendations, published in the journal Stroke, emphasize the importance of controlling blood pressure, especially in young women. They are aimed at a broader age range than most recommendations.
A stroke occurs when the blood supply to the brain is blocked or when a blood vessel in the brain ruptures, causing brain tissue to die.
The signs of stroke in women are similar to those in men, including face drooping, sudden numbness or weakness of the arm, and difficulty with speech or trouble understanding. But symptoms in women may be more vague or subtle.
Women are more likely to have a change in their consciousness or their ability to communicate, she said.
An estimated 6.8 million people in the United States are living after having had a stroke, including 3.8 million women, according to statistics from the American Heart Association. Each year, more than half of the estimated 800,000 people who have a stroke each year are women.
As women increasingly outlive men, their lifetime risk of stroke becomes higher. Women are also more likely to be living alone and widowed after suffering a stroke, and are more likely to be institutionalized, research shows.