Special Considerations for Primary and Secondary Stroke Prevention in Women

Deema Alrasheed; Cheryl Jaigobin

doi:10.1055/s-0037-1603684

Seminars in Neurology, Table of Contents

Semin Neurol 2017; 37(03): 376-382
DOI: 10.1055/s-0037-1603684

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Special Considerations for Primary and Secondary Stroke Prevention in Women

Authors

Deema Alrasheed

¹Division of Neurology, University Health Network Stroke Program, University of Toronto, Toronto, Canada
Cheryl Jaigobin

¹Division of Neurology, University Health Network Stroke Program, University of Toronto, Toronto, Canada

²Department of Medicine, University of Toronto, Toronto, Canada

Abstract

There are gender differences in stroke in several areas. Overall, the incidence of stroke is greater in women because of the increased risk of stroke with increasing age and the longer life expectancy of women. However, gender-specific risk factors for stroke include hormonal changes during pregnancy and exogenous hormonal therapies. Also, cerebral venous thrombosis, thrombophilia, and migraine are more prevalent in women. These gender differences are the subject of this review.

Keywords

stroke - women - prevention - pregnancy - gender

Full Text

References

References
1 Moatti Z, Gupta M, Yadava R, Thamban S. A review of stroke and pregnancy: incidence, management and prevention. Eur J Obstet Gynecol Reprod Biol 2014; 181: 20-27
2 Bushnell C, McCullough L, Awad I. , et al. Guidelines for the Prevention of Stroke in Women. Stroke. 2014 . Available at: https://doi.org/10.1161/01.str.0000442009.06663.48 . Accessed September 26, 2016
3 Tettenborn B. Stroke and pregnancy. Neurol Clin 2012; 30 (03) 913-924
4 Roberts JM, August PA, Bakris G. , et al; American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013; 122 (05) 1122-1131
5 Xu TT, Zhou F, Deng CY, Huang GQ, Li JK, Wang XD. Low-dose aspirin for preventing preeclampsia and its complications: a meta-analysis. J Clin Hypertens (Greenwich) 2015; 17 (07) 567-573
6 Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2014; (02) CD002252
7 Magee LA, von Dadelszen P, Rey E. , et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med 2015; 372 (05) 407-417
8 Magee LA, Helewa M, Moutquin JM, von Dadelszen P. ; Hypertension Guideline Committee; Strategic Training Initiative in Research in the Reproductive Health Sciences (STIRRHS) Scholars. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. J Obstet Gynaecol Can 2008; 30 (3, Suppl): S1-S48
9 ElFarra J, Bean C, Martin Jr JN. Management of hypertensive crisis for the obstetrician/gynecologist. Obstet Gynecol Clin North Am 2016; 43 (04) 623-637
10 Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev 2010; (11) CD000025
11 Sass N, Itamoto CH, Silva MP, Torloni MR, Atallah AN. Does sodium nitroprusside kill babies? A systematic review. Sao Paulo Med J 2007; 125 (02) 108-111
12 Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther 2008; 26 (01) 38-49
13 American Diabetes Association. 12. Management of diabetes in pregnancy. Diabetes Care 2016; 39 (Suppl. 01) S94-S98
14 Mukherjee M. Dyslipidemia in pregnancy. Expert analysis, America College of Cardiology. 2014 . Available at: http://www.acc.org/latest-in-cardiology/articles/2014/07/18/16/08/dyslipidemia-in-pregnancy . Accessed November 28, 2016
15 Kelly JC, Safain MG, Roguski M, Edlow AG, Malek AM. Postpartum internal carotid and vertebral arterial dissections. Obstet Gynecol 2014; 123 (04) 848-856
16 Reinhard M, Munz M, von Kannen AL, Griesser-Leute HJ, Dittrich R, Engelter ST. Risk of recurrent cervical artery dissection during pregnancy, childbirth and puerperium. Eur J Neurol 2015; 22 (04) 736-739
17 Moroz L, Airoldi J, Almario C, Greenberg M, Berghella V, Baxter J. Prophylactic treatment during pregnancy for women with a history of vertebral artery dissection. Am J Obstet Gynecol 2006; 195 (06) S104
18 Abecassis P, Lecinq A, Roger-Christoph S, Mercier FJ, Benhamou D. [Management of delivery in patients with Marfan's syndrome presenting aortic dilatation]. J Gynecol Obstet Biol Reprod (Paris) 2004; 33 (05) 416-420
19 Lamy C, Hamon JB, Coste J, Mas JL. ; French Study Group on Stroke in Pregnancy. Ischemic stroke in young women: risk of recurrence during subsequent pregnancies. Neurology 2000; 55 (02) 269-274
20 Putaala J, Haapaniemi E, Metso AJ. , et al. Recurrent ischemic events in young adults after first-ever ischemic stroke. Ann Neurol 2010; 68 (05) 661-671
21 Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. ; American College of Chest Physicians. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl): e691S-e736S
22 Gupta U, Cook JC, Tassinari MS, Hurtt ME. Comparison of developmental toxicology of aspirin (acetylsalicylic acid) in rats using selected dosing paradigms. Birth Defects Res B Dev Reprod Toxicol 2003; 68 (01) 27-37
23 Kozer E, Nikfar S, Costei A, Boskovic R, Nulman I, Koren G. Aspirin consumption during the first trimester of pregnancy and congenital anomalies: a meta-analysis. Am J Obstet Gynecol 2002; 187 (06) 1623-1630
24 Askie LM, Duley L, Henderson-Smart DJ, Stewart LA. ; PARIS Collaborative Group. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet 2007; 369 (9575): 1791-1798
25 Gould MK, Dembitzer AD, Doyle RL, Hastie TJ, Garber AM. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. A meta-analysis of randomized, controlled trials. Ann Intern Med 1999; 130 (10) 800-809
26 Quinlan DJ, McQuillan A, Eikelboom JW. Low-molecular-weight heparin compared with intravenous unfractionated heparin for treatment of pulmonary embolism: a meta-analysis of randomized, controlled trials. Ann Intern Med 2004; 140 (03) 175-183
27 Kaplan LC. Congenital Dandy Walker malformation associated with first trimester warfarin: a case report and literature review. Teratology 1985; 32 (03) 333-337
28 Xu Z, Li Y, Tang S, Huang X, Chen T. Current use of oral contraceptives and the risk of first-ever ischemic stroke: a meta-analysis of observational studies. Thromb Res 2015; 136 (01) 52-60
29 Gillum LA, Mamidipudi SK, Johnston SC. Ischemic stroke risk with oral contraceptives: a meta-analysis. JAMA 2000; 284 (01) 72-78
30 Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366 (24) 2257-2266
31 Kemmeren JM, Tanis BC, van den Bosch MA. , et al. Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke. Stroke 2002; 33 (05) 1202-1208
32 Urbanus RT, Siegerink B, Roest M, Rosendaal FR, de Groot PG, Algra A. Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study. Lancet Neurol 2009; 8 (11) 998-1005
33 Piepoli MF, Hoes AW, Agewall S. , et al; Authors/Task Force Members. 2016 European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2016; 37 (29) 2315-2381
34 Curtis KM, Tepper NK, Jatlaoui TC. , et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65 (3, No. RR-3): 1-103
35 Black A, Guilbert E, Costescu D. , et al; Co-Authors; Special Contributors. Canadian Contraception Consensus (Part 2 of 4). J Obstet Gynaecol Can 2015; 37 (11) 1033-1039
36 Lisabeth L, Bushnell C. Stroke risk in women: the role of menopause and hormone therapy. Lancet Neurol 2012; 11 (01) 82-91
37 Rocca WA, Grossardt BR, Miller VM, Shuster LT, Brown Jr RD. Premature menopause or early menopause and risk of ischemic stroke. Menopause 2012; 19 (03) 272-277
38 Grady D, Herrington D, Bittner V. , et al; HERS Research Group. Cardiovascular Disease Outcomes during 6.8 Years of Hormone Therapy: Heart and Estrogen/Progestin Replacement Study Follow-Up (HERS II). JAMA 2002; 288 (01) 49-57
39 Viscoli CM, Brass LM, Kernan WN, Sarrel PM, Suissa S, Horwitz RI. A Clinical Trial of Estrogen-Replacement Therapy After Ischemic Stroke. N Engl J Med 2001; 345 (17) 1243-1249
40 Rossouw JE, Anderson GL, Prentice RL. , et al; Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 288 (03) 321-333
41 Canonico M, Carcaillon L, Plu-Bureau G. , et al. Postmenopausal hormone therapy and risk of stroke: impact of the route of estrogen administration and type of progestogen. Stroke 2016; 47 (07) 1734-1741
42 de Villiers TJ, Hall JE, Pinkerton JV. , et al. Revised global consensus statement on menopausal hormone therapy. Maturitas 2016; 91: 153-155
43 Goodman NF, Cobin RH, Ginzburg SB, Katz IA, Woode DE. ; American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of menopause. Endocr Pract 2011; 17 (06) (Suppl. 06) 1-25
44 Reid R, Abramson BL, Blake J. , et al; Menopause and Osteoporosis Working Group. Managing menopause. J Obstet Gynaecol Can 2014; 36 (09) 830-833
45 Spector JT, Kahn SR, Jones MR, Jayakumar M, Dalal D, Nazarian S. Migraine headache and ischemic stroke risk: an updated meta-analysis. Am J Med 2010; 123 (07) 612-624
46 Schürks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ 2009; 339: b3914
47 MacClellan LR, Giles W, Cole J. , et al. Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke 2007; 38 (09) 2438-2445
48 Hicks T, Stewart F, Eisinga A. NOACs versus warfarin for stroke prevention in patients with AF: a systematic review and meta-analysis. Open Heart 2016; 3 (01) e000279
49 Connolly SJ, Ezekowitz MD, Yusuf S. , et al; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361 (12) 1139-1151
50 Granger CB, Alexander JH, McMurray JJ. , et al; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365 (11) 981-992
51 Pancholy SB, Sharma PS, Pancholy DS, Patel TM, Callans DJ, Marchlinski FE. Meta-analysis of gender differences in residual stroke risk and major bleeding in patients with nonvalvular atrial fibrillation treated with oral anticoagulants. Am J Cardiol 2014; 113 (03) 485-490
52 Alamowitch S, Eliasziw M, Barnett HJ. ; North American Symptomatic Carotid Endarterectomy Trial (NASCET); ASA Trial Group; Carotid Endarterectomy (ACE) Trial Group. The risk and benefit of endarterectomy in women with symptomatic internal carotid artery disease. Stroke 2005; 36 (01) 27-31
53 Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJM. ; Carotid Endarterectomy Trialists Collaboration. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 2004; 363 (9413): 915-924
54 Rothwell PM, Eliasziw M, Gutnikov SA, Warlow CP, Barnett HJM. Sex difference in the effect of time from symptoms to surgery on benefit from carotid endarterectomy for transient ischemic attack and nondisabling stroke. Stroke 2004; 35 (12) 2855-2861
55 Howard VJ, Lutsep HL, Mackey A. , et al; CREST investigators. Influence of sex on outcomes of stenting versus endarterectomy: a subgroup analysis of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Lancet Neurol 2011; 10 (06) 530-537
56 De Rango P, Brown MM, Leys D. , et al. Management of carotid stenosis in women: consensus document. Neurology 2013; 80 (24) 2258-2268