HealthDay News —  The American Heart Association has issued gender-specific guidelines aimed at reducing strokes based on risk factors unique to women.

Women are disproportionately affected by stroke. Of the estimated 6.8 million people living in the U.S. after surviving a stroke, 3.8 million are women. In addition, stroke is the fifth leading cause of death for men, but third for women.

Cheryl Bushnell, MD, of Wake Forest Baptist Medical Center in Winston-Salem, N.C., and colleagues from the AHA Stroke Council, co-authored the guidelines, which were published online in Stroke: Journal of the American Heart Association.

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They reviewed relevant articles from the medical literature on stroke risk factors that are more common in adult women throughout their lifespan. The joint AHA/American College of Cardiology and supplementary AHA Stroke Council methods were used to classify the level of certainty and the class and level of evidence.

The council recommended that women with a history of hypertension prior to pregnancy be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks. Preeclampsia doubles the risk for stroke later in life, and thus, preeclampsia should be recognized as a stroke risk factor well after pregnancy.

Prior to taking oral contraceptives, women should be screened for hypertension, as the combination raises stroke risks. Stroke risk is higher in women who have migraine headaches with aura and in those who smoke. Atrial fibrillation in women over age 75 years also heightens stroke risk.

“To more accurately reflect the risk of stroke in women across the lifespan, as well as the clear gaps in current risk scores, we believe a female-specific stroke risk score is warranted,” the group wrote.

Both the Association of Neurological Surgeons and the Congress of Neurological Surgeons have endorsed the new guidelines.


  1. Bushnell C et al. Stroke. 2014; doi: 10.1161/01.str.0000442009.06663.48.