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Could You Have a Stroke?

By Jennifer B. Lemoine, DNP, APRN, NNP-BC

Could You Have a Stroke?

Stroke probably isn’t something you worry about most days, but did you know 1 in 5 women will have a stroke at some point in their lives? Your risk for stroke is influenced by whether you’ve ever been pregnant, take birth control pills, have migraine headaches that include auras, among other factors. Approximately 3 out of 10,000 pregnant women will have a stroke during pregnancy, compared to 2 out of 10,000 non-pregnant women.

For the first time, guidelines have been developed by the American Heart Association to address the unique stroke risk factors in women because of hormones, pregnancy and childbirth.

 

New stroke guidelines for women

The biggest risks for stroke—whether you smoke, are obese or have high cholesterol—are common to both women and men. However, high blood pressure and migraine headaches with visual changes (auras) are stroke risk factors more common in women. The hormonal changes that occur throughout a woman’s life, including those before, during and after pregnancy, can increase the risk even more!

Preeclampsia and eclampsia are blood pressure disorders during pregnancy that cause major complications, including stroke during or after delivery, premature birth, and risk for stroke long after childbearing. Preeclampsia is observed through high blood pressure and high protein levels in your urine, and when seizure also occurs, this is called eclampsia.

Here’s how to recognize and manage your risks for stroke:

Pre-Pregnancy
1. Birth control pills: Doubles stroke risk, particularly with existing high blood pressure

Manage your risks:

·  Get screened for high blood pressure before taking birth control pills

·  Know that smoking while taking birth control pills increases stroke risk

·  Don’t smoke, quit smoking

2. Migraine headaches: Women with migraine headaches with aura, and who smoke, are more likely to have a stroke

Manage your risks:

·  Quit smoking

3. High blood pressure: Increases risks pre-pregnancy for preeclampsia

Manage your risks:

·  Discuss with your healthcare provider using low-dose aspirin, starting in the second trimester (week 13+)

·  Also discuss if you should take calcium supplements to reduce preeclampsia risk

 

 

Pregnancy
1. High blood pressure: Highest incidence of stroke is in the 3rd trimester or during the postpartum period

Manage your risks:

·  High blood pressure in pregnancy should be evaluated and treated with medication, as needed

2. Preeclampsia: High blood pressure that develops in pregnancy

Manage your risks:

·  Blood pressure readings of 150-15mmHg/100-109mmHg may need treatment via medication; your healthcare provider can discuss the risks for you and your baby

·  Blood pressure readings of 160/110mmHg or higher should always be treated

 

 

Post-Pregnancy
1. History of preeclampsia: Doubles your risk of stroke; quadruples high blood pressure risks later in life

Manage your risks:

·  Know your increased stroke and high blood pressure risk factors

·  Get screened for high blood pressure 6 months-1 year after birth

·  Get screened for other stroke risk factors: obesity, smoking and high cholesterol

 
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Nurses explain why they check your blood pressure and urine at each prenatal visit


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