AHA/ASA guideline recommendations for prevention of stroke in women overview: Difference between revisions
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In general, women have a lower incidence of ischemic stroke than men. Women have a longer life expectancy than men, therefore, at ages 85 years and older, women have a higher<ref name="pmid19211484">{{cite journal| author=Petrea RE, Beiser AS, Seshadri S, Kelly-Hayes M, Kase CS, Wolf PA| title=Gender differences in stroke incidence and poststroke disability in the Framingham heart study. | journal=Stroke | year= 2009 | volume= 40 | issue= 4 | pages= 1032-7 | pmid=19211484 | doi=10.1161/STROKEAHA.108.542894 | pmc=PMC2676725 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19211484 }} </ref> or similar incidences of stroke with men.<ref name="pmid19211488">{{cite journal| author=Appelros P, Stegmayr B, Terént A| title=Sex differences in stroke epidemiology: a systematic review. | journal=Stroke | year= 2009 | volume= 40 | issue= 4 | pages= 1082-90 | pmid=19211488 | doi=10.1161/STROKEAHA.108.540781 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19211488 }} </ref> A population-based incidence study also noted a ≥2-fold increase in stroke incidence among blacks and Hispanics when compared with whites.<ref name="pmid9482500">{{cite journal| author=Sacco RL, Boden-Albala B, Gan R, Chen X, Kargman DE, Shea S et al.| title=Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study. | journal=Am J Epidemiol | year= 1998 | volume= 147 | issue= 3 | pages= 259-68 | pmid=9482500 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9482500 }} </ref> | In general, women have a lower incidence of ischemic stroke than men. Women have a longer life expectancy than men, therefore, at ages 85 years and older, women have a higher<ref name="pmid19211484">{{cite journal| author=Petrea RE, Beiser AS, Seshadri S, Kelly-Hayes M, Kase CS, Wolf PA| title=Gender differences in stroke incidence and poststroke disability in the Framingham heart study. | journal=Stroke | year= 2009 | volume= 40 | issue= 4 | pages= 1032-7 | pmid=19211484 | doi=10.1161/STROKEAHA.108.542894 | pmc=PMC2676725 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19211484 }} </ref> or similar incidences of stroke with men.<ref name="pmid19211488">{{cite journal| author=Appelros P, Stegmayr B, Terént A| title=Sex differences in stroke epidemiology: a systematic review. | journal=Stroke | year= 2009 | volume= 40 | issue= 4 | pages= 1082-90 | pmid=19211488 | doi=10.1161/STROKEAHA.108.540781 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19211488 }} </ref> A population-based incidence study also noted a ≥2-fold increase in stroke incidence among blacks and Hispanics when compared with whites.<ref name="pmid9482500">{{cite journal| author=Sacco RL, Boden-Albala B, Gan R, Chen X, Kargman DE, Shea S et al.| title=Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study. | journal=Am J Epidemiol | year= 1998 | volume= 147 | issue= 3 | pages= 259-68 | pmid=9482500 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9482500 }} </ref> | ||
====Hemorrhagic Stroke==== | ====Hemorrhagic Stroke==== | ||
There is an increased prevalence of [[subarachnoid hemorrhage]] in women,<ref name="pmid18162891">{{cite journal| author=Shea AM, Reed SD, Curtis LH, Alexander MJ, Villani JJ, Schulman KA| title=Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003. | journal=Neurosurgery | year= 2007 | volume= 61 | issue= 6 | pages= 1131-7; discussion 1137-8 | pmid=18162891 | doi=10.1227/01.neu.0000306090.30517.ae | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18162891 }} </ref><ref name="pmid19571544">{{cite journal| author=Sacco S, Totaro R, Toni D, Marini C, Cerone D, Carolei A| title=Incidence, case-fatalities and 10-year survival of subarachnoid hemorrhage in a population-based registry. | journal=Eur Neurol | year= 2009 | volume= 62 | issue= 3 | pages= 155-60 | pmid=19571544 | doi=10.1159/000226617 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19571544 }} </ref> which has been linked to an increased prevalence of [[cerebral aneurysms]].<ref name="pmid10648430">{{cite journal| author=Wardlaw JM, White PM| title=The detection and management of unruptured intracranial aneurysms. | journal=Brain | year= 2000 | volume= 123 ( Pt 2) | issue= | pages= 205-21 | pmid=10648430 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10648430 }} </ref> | There is an increased prevalence of [[subarachnoid hemorrhage]] in women,<ref name="pmid18162891">{{cite journal| author=Shea AM, Reed SD, Curtis LH, Alexander MJ, Villani JJ, Schulman KA| title=Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003. | journal=Neurosurgery | year= 2007 | volume= 61 | issue= 6 | pages= 1131-7; discussion 1137-8 | pmid=18162891 | doi=10.1227/01.neu.0000306090.30517.ae | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18162891 }} </ref><ref name="pmid19571544">{{cite journal| author=Sacco S, Totaro R, Toni D, Marini C, Cerone D, Carolei A| title=Incidence, case-fatalities and 10-year survival of subarachnoid hemorrhage in a population-based registry. | journal=Eur Neurol | year= 2009 | volume= 62 | issue= 3 | pages= 155-60 | pmid=19571544 | doi=10.1159/000226617 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19571544 }} </ref> which has been linked to an increased prevalence of [[cerebral aneurysms]].<ref name="pmid10648430">{{cite journal| author=Wardlaw JM, White PM| title=The detection and management of unruptured intracranial aneurysms. | journal=Brain | year= 2000 | volume= 123 ( Pt 2) | issue= | pages= 205-21 | pmid=10648430 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10648430 }} </ref> Conversely, the incidence of [[intracerebral hemorrhage]], in most cases, has been reported to be lower in women when compared with men.<ref name="pmid11032611">{{cite journal| author=Nilsson OG, Lindgren A, Ståhl N, Brandt L, Säveland H| title=Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden. | journal=J Neurol Neurosurg Psychiatry | year= 2000 | volume= 69 | issue= 5 | pages= 601-7 | pmid=11032611 | doi= | pmc=PMC1763383 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11032611 }} </ref> The highest incidence of ICH was also observed among the black population as compared with hispanics and white population. | ||
==Risk Factors== | |||
{| Class="wikitable" | |||
!Sex-specific | |||
!Stronger or commoner in women | |||
!Similar prevalence in both sexes | |||
|- | |||
|[[Pregnancy]] | |||
|[[Migraine|Migraine with aura]] | |||
|[[Physical inactivity]] | |||
|- | |||
|[[Preeclampsia]] | |||
|[[Atrial fibrillation]] | |||
|[[Age]] | |||
|- | |||
|[[Gestational diabetes]] | |||
|[[Diabetes mellitus]] | |||
|Prior cardiovascular disease | |||
|- | |||
|[[Oral contraceptive]]s | |||
|[[Hypertension]] | |||
|[[Obesity]] | |||
|- | |||
|Postmenopausal hormone use | |||
|[[Depression]]<ref name="pmid20561675">{{cite journal| author=O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P et al.| title=Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. | journal=Lancet | year= 2010 | volume= 376 | issue= 9735 | pages= 112-23 | pmid=20561675 | doi=10.1016/S0140-6736(10)60834-3 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20561675 }} </ref> | |||
|[[Diet]] | |||
|- | |||
|Changes in hormonal status | |||
|Psychosocial stress | |||
|[[Smoking]] | |||
|- | |||
| | |||
| | |||
|[[Metabolic syndrome]] | |||
|} | |||
''Adapted from AHA/ASA guideline recommendations for prevention of stroke in women (2014)''<ref name="pmid24503673">{{cite journal| author=Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL et al.| title=Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. | journal=Stroke | year= 2014 | volume= | issue= | pages= | pmid=24503673 | doi=10.1161/01.str.0000442009.06663.48 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24503673 }} </ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WS}} | |||
{{WH}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Aging-associated diseases]] | [[Category:Aging-associated diseases]] | ||
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[[Category:Neurosurgery]] | [[Category:Neurosurgery]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Latest revision as of 19:37, 14 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]
Overview
The incidence of stroke, especially in women, is fast-rising. Stroke is the third leading cause of death in women and fifth in men.[1] Many studies have documented the fact that women are more adversely affected by stroke and its complications, in terms of functional recovery, quality of life when compared to men.[2][3][4] Therefore, it is important to provide guidelines to identify high-risk women for stroke, and also to provide recommendations regarding prevention of stroke.
Epidemioloogy and Dermographics
Ischemic Stroke
In general, women have a lower incidence of ischemic stroke than men. Women have a longer life expectancy than men, therefore, at ages 85 years and older, women have a higher[5] or similar incidences of stroke with men.[6] A population-based incidence study also noted a ≥2-fold increase in stroke incidence among blacks and Hispanics when compared with whites.[7]
Hemorrhagic Stroke
There is an increased prevalence of subarachnoid hemorrhage in women,[8][9] which has been linked to an increased prevalence of cerebral aneurysms.[10] Conversely, the incidence of intracerebral hemorrhage, in most cases, has been reported to be lower in women when compared with men.[11] The highest incidence of ICH was also observed among the black population as compared with hispanics and white population.
Risk Factors
Sex-specific | Stronger or commoner in women | Similar prevalence in both sexes |
---|---|---|
Pregnancy | Migraine with aura | Physical inactivity |
Preeclampsia | Atrial fibrillation | Age |
Gestational diabetes | Diabetes mellitus | Prior cardiovascular disease |
Oral contraceptives | Hypertension | Obesity |
Postmenopausal hormone use | Depression[12] | Diet |
Changes in hormonal status | Psychosocial stress | Smoking |
Metabolic syndrome |
Adapted from AHA/ASA guideline recommendations for prevention of stroke in women (2014)[13]
References
- ↑ "Products - Health United States - Tables - 2011 Complete List". Retrieved 11 February 2014.
- ↑ Gall, SL.; Tran, PL.; Martin, K.; Blizzard, L.; Srikanth, V. (2012). "Sex differences in long-term outcomes after stroke: functional outcomes, handicap, and quality of life". Stroke. 43 (7): 1982–7. doi:10.1161/STROKEAHA.111.632547. PMID 22569940. Unknown parameter
|month=
ignored (help) - ↑ Gargano, JW.; Reeves, MJ. (2007). "Sex differences in stroke recovery and stroke-specific quality of life: results from a statewide stroke registry". Stroke. 38 (9): 2541–8. doi:10.1161/STROKEAHA.107.485482. PMID 17673706. Unknown parameter
|month=
ignored (help) - ↑ Kim, JS.; Lee, KB.; Roh, H.; Ahn, MY.; Hwang, HW. (2010). "Gender differences in the functional recovery after acute stroke". J Clin Neurol. 6 (4): 183–8. doi:10.3988/jcn.2010.6.4.183. PMID 21264198. Unknown parameter
|month=
ignored (help) - ↑ Petrea RE, Beiser AS, Seshadri S, Kelly-Hayes M, Kase CS, Wolf PA (2009). "Gender differences in stroke incidence and poststroke disability in the Framingham heart study". Stroke. 40 (4): 1032–7. doi:10.1161/STROKEAHA.108.542894. PMC 2676725. PMID 19211484.
- ↑ Appelros P, Stegmayr B, Terént A (2009). "Sex differences in stroke epidemiology: a systematic review". Stroke. 40 (4): 1082–90. doi:10.1161/STROKEAHA.108.540781. PMID 19211488.
- ↑ Sacco RL, Boden-Albala B, Gan R, Chen X, Kargman DE, Shea S; et al. (1998). "Stroke incidence among white, black, and Hispanic residents of an urban community: the Northern Manhattan Stroke Study". Am J Epidemiol. 147 (3): 259–68. PMID 9482500.
- ↑ Shea AM, Reed SD, Curtis LH, Alexander MJ, Villani JJ, Schulman KA (2007). "Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003". Neurosurgery. 61 (6): 1131–7, discussion 1137-8. doi:10.1227/01.neu.0000306090.30517.ae. PMID 18162891.
- ↑ Sacco S, Totaro R, Toni D, Marini C, Cerone D, Carolei A (2009). "Incidence, case-fatalities and 10-year survival of subarachnoid hemorrhage in a population-based registry". Eur Neurol. 62 (3): 155–60. doi:10.1159/000226617. PMID 19571544.
- ↑ Wardlaw JM, White PM (2000). "The detection and management of unruptured intracranial aneurysms". Brain. 123 ( Pt 2): 205–21. PMID 10648430.
- ↑ Nilsson OG, Lindgren A, Ståhl N, Brandt L, Säveland H (2000). "Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden". J Neurol Neurosurg Psychiatry. 69 (5): 601–7. PMC 1763383. PMID 11032611.
- ↑ O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P; et al. (2010). "Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study". Lancet. 376 (9735): 112–23. doi:10.1016/S0140-6736(10)60834-3. PMID 20561675.
- ↑ Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL; et al. (2014). "Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association". Stroke. doi:10.1161/01.str.0000442009.06663.48. PMID 24503673.
- Pages with citations using unsupported parameters
- CS1 maint: Multiple names: authors list
- CS1 maint: PMC format
- CS1 maint: Explicit use of et al.
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