The Risk: Preeclampsia. This condition is a significant risk factor during and after pregnancy, so if you’re trying to put a bun in the oven, prevention is key. The guidelines recommend that women with chronic hypertension or previous pregnancy-related hypertension take low-dose aspirin from the 12th week of gestation until delivery. And if you consume less than 600 mg daily of calcium, you should consider taking calcium supplements. If you have high blood pressure during pregnancy, speak to your doctor about ways to control it. There are antihypertensive drugs that can be used safely during pregnancy, and there are also lifestyle changes that could help. If you do develop preeclampsia, you are at an increased risk of future hypertension and stroke. This makes it especially important to keep up with follow-up visits to your primary care physician. The Risk: Oral Contraception. Taking birth control pills puts you at risk for stroke. This is why the guidelines recommend having your blood pressure monitored before starting to take birth control pills. And if you smoke, forget about it. “We know that even younger women who take birth control pills and smoke have a very elevated risk of both heart attack and stroke,” says Prevention advisor Steven Nissen, MD, chairman of the department of cardiovascular medicine at The Cleveland Clinic. “In fact, so much so that it would be considered malpractice for a physician to prescribe birth control pills to a woman who smokes.” The Risk: Hormone Replacement Therapy (HRT). Research shows that HRT has been linked to cardiovascular disease risk. The guidelines reiterate that these therapies should not be used to prevent stroke. The Risk: Migraine with Aura. Women are four times more likely to get migraines than men. Migraine with aura is defined as a typical migraine headache plus the presence of visual disturbance, unilateral tingling, or pins and needles sensation; or numbness, unilateral weakness, or speech difficulty that might precede the headache. Tell your doctor about your migraines if you haven’t already, since there is an association between higher migraine frequency and stroke risk. While evidence is lacking about whether decreasing migraine frequency could decrease stroke risk, it may not be a bad idea to treat them, the guidelines say. The Risk: Atrial Fibrillation (AF). This is the most common heart rhythm problem and a major modifiable risk factor for stroke. In fact, AF increases the risk of stroke 4- to 5-fold. As women get older, our risk for atrial fibrillation increases. See your doctor if you feel your heart racing, skipping beats, or doing anything out of the ordinary. Controlling AF can help lower your stroke risk. The Most Important Risk: High Blood Pressure. “The link between high blood pressure and stroke is one of the most profound in all of medicine,” says Dr. Nissen. If you lower your blood pressure, you lower your risk of stroke. And the best way to do that: “Live a healthy lifestyle that includes exercise and good nutrition,” says Cheryl Bushnell, MD, author of the guidelines, which were published in the journal Stroke. What does that look like? Regular physical activity, moderate alcohol consumption (less than one drink per day for women), no smoking, and a diet rich in fruits, vegetables, grains, nuts, olive oil, and low in saturated fat. And recent research backs up these recommendations: A recent meta-analysis published in The American Journal of Medicine found that a whole foods diet reduces cardiovascular risk factors more so than diets that just focus on being low-fat. Plus, research presented at this month’s International Stroke Conference 2014 in San Diego found that moderate intensity exercise, like brisk walking, was associated with a 20% reduced stroke risk compared to not doing activity at all. More from Prevention: A Healthier Heart In 30 Days
