St. Michael’s Neurologist part of group that wrote American Heart Association guidelines for preventing strokes in women
Toronto, February 6, 2014
By Leslie Shepherd
Dr. Gustavo Saposnik
A neurologist at St. Michael’s Hospital was part of the group that developed the first American Heart Association/American Stroke Foundation guidelines for preventing stroke in women.
The guidelines, published today in the American Heart Association journal Stroke, note that women share many of the same stroke risk factors as men. However, high blood pressure, migraines with aura, atrial fibrillation, diabetes, depression and emotional stress are risk factors that tend to be stronger or more common in women. In addition, stroke risk in women is influenced by hormones, reproductive health, pregnancy and childbirth.
Dr. Gustavo Saposnik, a St. Michael’s neurologist, was part of the oversight committee that developed the guidelines, which outline stroke risks unique to women and provide evidence-based recommendations on how best to treat them.
Strokes are the third leading cause of death in Canada, killing more than 13,000 people a year. While it’s the fifth leading cause of death for men, it’s the third leading cause of death for women. Men have a slightly higher prevalence of living with the effects of a stroke (51 per cent vs. 49) but 59 per cent of stroke deaths occur in women, likely because women live longer and men are more likely to die from other causes. With the population aging, the number of women who have strokes is expected to rise.
The new guidelines, aimed at primary care providers, including OB-GYNs, say:
- Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks. Preeclampsia and eclampsia are blood pressure disorders during pregnancy that cause major complications, including stroke during or after delivery, premature birth, and raise stroke risk well after child-bearing.
- Women who have had preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol, and obesity in these women should be treated early.
- Pregnant women with moderately high blood pressure may be considered for blood pressure medication, whereas expectant mothers with severe high blood pressure should be treated.
- Women should be screened for high blood pressure before being prescribed birth control pills because they raise blood pressure in some women.
- Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
- Women over age 75 should be screened for the irregular heart rhythm atrial fibrillation due to its link to higher stroke risk.
About St. Michael's Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
For more information, or to arrange an interview with Dr. Saposnik, contact:
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