Something significant happened in early February, heart month, when the American Heart Association/American Stroke Association reported that women may benefit from their own stroke guidelines. Who knew? Heart month usually focuses on heart disease and raising awareness of women and heart disease.
But we've been ignoring stroke, no doubt about it. It's a brain attack versus a heart attack and is the fifth leading cause of death for men but the third for women. According to Canada's Heart and Stroke Foundation, there are an estimated 50,000 strokes in Canada each year -- one stroke every 10 minutes. Few of us realize that 60 per cent of all strokes occur in women, not men. And fewer still realize that high blood pressure, migraine with aura, atrial fibrillation, diabetes, depression and emotional stress are risk factors that tend to be stronger or more common in women than men.
"Men are physiologically different from women, so preventive tips cannot be one-size fits all," Dr. Virginia Howard, co-author of the new Guidelines for the Prevention of Stroke in Women told www.sciencedaily.com. "There are many considerations about stroke that might be different for women: Reproductive factors and risk factors more common or stronger in women, like diabetes and atrial fibrillation, might get lost in a general guidelines document." Since pregnancy, childbirth and hormones can impact stroke risk for women, this committee decided to draft some women-specific guidelines.
Among their recommendations:
- Screen women for high blood pressure before prescribing birth control pills which can raise blood pressure in some people.
- Consider giving low-dose aspirin and/or a calcium supplement as therapy to lower pre-eclampsia risk in women with a history of high blood pressure before pregnancy.
- Pregnant women with elevated blood pressure should discuss with their physicians possible blood pressure medication; pregnant women with severe high blood pressure should take medication.
- Women who suffer from migraines with aura should not smoke.
- Women over the age of 75 should be screened for atrial fibrillation.
These recommendations are significant when you consider that 59 per cent of women, but only 39 per cent of men, have strokes related to high blood pressure. We've done a good job in recognizing, after decades, the risks of heart disease in women.
Now it's stroke's turn.
When asked why the new guidelines may help women, Dr. Suzanne Steinbaum, director of Women's Heart Health at New York City's Lenox Hill Hospital told WebMD: "Whenever I give a talk, I ask what people think is the greatest risk to women's health and they say breast cancer. I don't think stroke is on the same level of consciousness."
Women have a higher lifetime risk of stroke than men and tend to do worse post-stroke in that they have a lower quality of life and may end up in long-term care. According to Canada's Heart and Stroke Foundation, more than 80 per cent of people who have a stroke and make it to the hospital will survive. But if and when they recover, will they protect themselves from another stroke? Unfortunately, a recent HSFO poll of 2,000 heart attack and stroke survivors indicates that when it comes to physical activity, managing stress and maintaining a healthy weight, more than half those who needed to make those changes couldn't maintain the changes or didn't try at all.
The changes required are actually simple ones and include eating a healthy diet, exercising at least 30 minutes most days of the week, quitting smoking, managing stress and, if you are a woman, limiting your alcohol intake to no more than two drinks a day to a weekly maximum of 10. But managing your health, never mind making those changes, is difficult. A recent Leger research survey commissioned by Argyle Communications reports that 61 per cent of Canadians integrate alternative health care into their overall approach to health. Women do this more than men. For more heart-healthy tips, check here.
New research indicates additional ways to protect against heart disease such as limiting your consumption of added sugar. According to a study published earlier this month in the Journal of American Medical Association's Internal Medicine, over 71 per cent of adults consumed 10 per cent or more of their calories from added sugar, and about ten percent of adults consumed 25 per cent or more of their calories from added sugar. Authors of the study noted that the risk of death from heart and stroke disease increased with a higher percentage of calories from added sugar.
When it comes to managing stroke risk, Dr. Steinbaum told WebMD that women should know their numbers: "Your blood pressure, your cholesterol, your blood sugar, your BMI. Knowing your family history is also very important. To prevent stroke it comes down to the basics, lifestyle changes. These are critical issues to address in order to reduce cardiovascular disease and prevent stroke."
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