AHA/ASA guideline recommendations for prevention of stroke in women overview: Difference between revisions

< AHA
Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 11: Line 11:
====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>  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.
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
|-
|[[Pregnancy]]
|[[Migraine|Migraine with aura]]
|-
|[[Preeclampsia]]
|[[Atrial fibrillation]]
|-
|[[Gestational diabetes]]
|Diabetes mellitus]]
|-
|[[Oral contraceptive]]s
|[[Hypertension]]
|-
|Hypertensive emergency with ARF/CRF
|Nicardipine or fenoldopam
|-
|Hypertensive encephalopathy
|Nicardipine, labetalol, fenoldopam <br> Note: The BP should not be lowered by more than 25%
|-
|Pre-eclampsia/eclampsia
|Labetalol or nicardipine
|-
|Sympathetic crisis/cocaine overdose
|Benzodiazepine + (verapamil, diltiazem, or nicardipine) <br> Note: Beta blockers should '''NOT''' be administered alone to prevent un-opposed alpha-adrenergic stimulation
|-
|Cerebrovascular accident
|Nicardipine, labetalol, fenoldopam, or clevidipine <br> Note: An expert's judgement is required to determine if the BP should be lowered.
|-
|Withdrawal of antihypertensive therapy e.g. clonidine or propanolol
|Re-administer the discontinued drug;  phentolamine, nitroprusside, or labetalol, if necessary
|}


==References==
==References==

Revision as of 21:18, 11 February 2014

Stroke Main page

Patient Information

Overview

Causes

Classification

Hemorrhagic stroke
Ischemic stroke

Differentiating Stroke from other Diseases

Epidemiology and Demographics

Diagnosis

NIH stroke scale
Glasgow coma scale

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

AHA/ASA guideline recommendations for prevention of stroke in women overview On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of AHA/ASA guideline recommendations for prevention of stroke in women overview

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on AHA/ASA guideline recommendations for prevention of stroke in women overview

CDC on AHA/ASA guideline recommendations for prevention of stroke in women overview

AHA/ASA guideline recommendations for prevention of stroke in women overview in the news

Blogs on AHA/ASA guideline recommendations for prevention of stroke in women overview

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for AHA/ASA guideline recommendations for prevention of stroke in women overview

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
Pregnancy Migraine with aura
Preeclampsia Atrial fibrillation
Gestational diabetes Diabetes mellitus]]
Oral contraceptives Hypertension
Hypertensive emergency with ARF/CRF Nicardipine or fenoldopam
Hypertensive encephalopathy Nicardipine, labetalol, fenoldopam
Note: The BP should not be lowered by more than 25%
Pre-eclampsia/eclampsia Labetalol or nicardipine
Sympathetic crisis/cocaine overdose Benzodiazepine + (verapamil, diltiazem, or nicardipine)
Note: Beta blockers should NOT be administered alone to prevent un-opposed alpha-adrenergic stimulation
Cerebrovascular accident Nicardipine, labetalol, fenoldopam, or clevidipine
Note: An expert's judgement is required to determine if the BP should be lowered.
Withdrawal of antihypertensive therapy e.g. clonidine or propanolol Re-administer the discontinued drug; phentolamine, nitroprusside, or labetalol, if necessary

References

  1. ↑ "Products - Health United States - Tables - 2011 Complete List". Retrieved 11 February 2014.
  2. ↑ 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)
  3. ↑ 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)
  4. ↑ 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)
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ Wardlaw JM, White PM (2000). "The detection and management of unruptured intracranial aneurysms". Brain. 123 ( Pt 2): 205–21. PMID 10648430.
  11. ↑ 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.

Template:WS Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=AHA/ASA_guideline_recommendations_for_prevention_of_stroke_in_women_overview&oldid=942375"