Women, Strokes and New Prevention Guidelines

By: Dr. Christine Horner

If you think that heart attacks and strokes associated with cardiovascular disease (CVD) are more of a concern for men than women, you are not alone. However, this long held belief is a myth. Cardiovascular disease is the leading cause of death for both men and women in the United States. In fact, more women than men die each year of CVD. In 2006, the number of deaths attributed to CVD was approximately 432,700 in women and 398,600 in men.

When it comes to strokes, women outnumber men as well. According to the American Heart Association (AHA) and American Stroke Association (ASA) about 55,000 more women than men suffer strokes each year. Stroke is the third leading cause of death for women; for men, it?s the fourth. One in five women will suffer from a stroke at some point in her life.

Why do women lead men in these categories? Women share the same risk factors as men for cardiovascular disease including high blood pressure, elevated cholesterol levels, smoking, diabetes mellitus, stress, poor diet, alcohol consumption, a sedentary lifestyle and obesity-especially abdominal obesity. But, women also have additional risk factors that men don?t have including pregnancy, taking birth control pills or hormone replacement therapy, and higher rates of depression and certain types of migraine headaches.

New Guidelines Issued By the AHA and ASA

The AHA and ASA issued new guidelines in March 2014 to help reduce the risk of strokes in women. Their recommendations include:

  • Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and or calcium supplement therapy to prevent pre-eclapsia-a serious blood pressure disorder that can occur during pregnancy.

  • Pregnant women with moderately high blood pressure (150-159mmHg/100-109mmHg) should be considered for blood pressure medication, and expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.

  • Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.

  • Smoking and the use of oral contraceptives increases the risk of stroke and should be avoided.

  • Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.

  • Postmenopausal women should not take hormone replacement therapy because it increases the risk of stroke.

  • All women over age 75 should be screened for atrial fibrillation risks, due to a link to higher stroke risk.

In addition to these recommendations, women should also pay close attention to all the diet and lifestyle risk factors that affect both sexes.

Here are 10 simple tips to lower your risk of a stroke and heart attack:

  • Move your body. Even mild to moderate activity including brisk walking, or riding your bike for 20 minutes has been shown to significantly lower your risk.

  • Eat more fruits and vegetables. Avoid sugar, processed foods and meats.

  • Eat a piece of dark chocolate several times a week. Dark chocolate contains flavonoids which help your arteries to stay flexible. Other properties in this delicious treat make arteries less likely to clot and prevent plaques from forming. Milk chocolate is does not have the same health benefits.

  • Go to bed by 10 PM. Research shows that staying up consistently late and getting fewer than 7 hours of sleep increases stress hormones, raises blood pressure, and effects blood sugar levels. Sleeping too much-more than 9 hours-increases your cardiovascular risk too. Going to bed by 10 PM and getting up by 6 PM are the most optimal health-promoting times to sleep.

  • Add fiber. According to a Harvard study published in 1999, women who eat 23 grams of fiber a day have 23% less heart attacks compared to women who eat eleven grams or less. Fiber only comes from plants-fruits, veggies, nuts, seeds, and whole grains.

  • Skip the soda and drink fresh purified water instead. Soda causes inflammation--a significant risk factor for heart disease and strokes. A study at Loma Linda University in California found that women who drank more than five glasses of water a day were half as likely to die from a heart attack, than those who drank less than two glasses. Good hydration promotes good circulation.

  • Cook with ginger and turmeric several times a week. Both have outstanding antioxidant and anti-inflammatory properties which lower the risk of most chronic diseases including CVD disease.

  • Put some oil in your tank: Consuming healthy fats every day, including omega-3 fatty acids found in flax seeds and wild caught salmon, and omega-9s found in olive oil has been shown by numerous studies to lower your risk of cardiovascular disease. A French study found that adults who regularly consume olive oil cut their chance of a stroke over 40%.

  • Take time out. Regular vacations have been found to lower the risk of heart disease by one third and practicing just twenty minutes of a meditation technique, called Transcendental meditation, can reduce your risk by over eighty percent. Stress is a major contributor to most chronic diseases, especially cardiovascular disease. Taking time out every day to relax and going on regular vacations does a lot to lower it.

  • Invite a friend to dinner. Numerous studies show that spending time with people who love and support you is one of the most potent medicines. A 2004 study published in the journal Heart found that having a very close relationship with another person, whether it is a friend, lover, or relative can cut the risk of a heart attack by fifty percent.

The good news is cardiovascular disease is mostly preventable. In fact, it is estimated that over ninety percent of strokes and heart attacks could be prevented through diet and lifestyle changes alone. Just trying one of the tips above can significantly lower your risk. Best yet, keeping your heart and brain healthy can be simple and fun with prescriptions like this: Take a vacation with a dear friend or lover and have a refreshing glass of purified water along with a square of delicious dark chocolate after a walk on the beach.

Coulter, S. ?Risk, Advances and Alarms.? Tex Heart Inst J. 2011; 38(2): 145-147.
Mitkam M. ?New guidelines focus on preventing stroke in women.? JAMA. 2014 Mar 12;311(10):1003-4. doi: 10.1001/jama.2014.1775

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