先兆子痫使女性中风的风险增加一倍, quadruples later high blood pressure risk
Millions of women with a history of preeclampsia should be screened and treated for high blood pressure, obesity, 吸烟和高胆固醇降低中风的风险, according to the first-ever guidelines from the 美国心脏协会 for preventing stroke in women.
在每年分娩的近400万妇女中, 专家估计，其中6%到10%的人会患上先兆子痫, 妊娠后期出现的危险的血压峰值.
Preeclampsia doubles the risk for stroke and quadruples the risk for high blood pressure later in life, 谢丽尔·布什内尔说, M.D., a neurologist and director of the Stroke Center at Wake Forest Baptist Medical Center who chaired the committee that wrote the guidelines.
“Many women and even clinicians are not aware of this association,” Bushnell said.
“Women who may think of themselves as very healthy may have this little blip of vascular disease during their childbearing years. 在那些年里发生的事情是极其重要的.”
In the U.S.在美国，中风在女性中比男性更常见. 在每年发生的79.5万例中风中，超过一半发生在女性身上. The disease is also more deadly, with about 60 percent of stroke deaths happening in women.
整个指南都强调了不吸烟的重要性. 在美国，吸烟是导致可预防死亡的首要原因.S., and a recent Surgeon General’s report found that stroke risk from secondhand smoke exposure increases an estimated 20-30 percent.
While women share many of the same risk factors for stroke as men – such as high blood pressure, smoking and diabetes – women have other risk factors that make them uniquely vulnerable, 莫尼克·奇罗说, M.D., an obstetrician and gynecologist at Duke University Medical School who helped write the guidelines.
这些弱点包括常见的妊娠并发症, 使用避孕药, hormone replacement therapy and a higher prevalence of migraines with visual disturbances and atrial fibrillation after age 75.
The new stroke prevention recommendations for women are based on the most current scientific research and include:
- All women with a history of preeclampsia should be regularly evaluated and treated for cardiovascular risk factors such as high blood pressure, obesity, 吸烟与高胆固醇. 风险因素筛查应在分娩后一年内开始.
- Pregnant women with high blood pressure or who experienced high blood pressure during a previous pregnancy should talk to their healthcare providers about whether they should take low-dose aspirin starting the second trimester until delivery to lower preeclampsia risk.
- Expecting mothers with severe high blood pressure (160/110 mmHg or above) should be treated with blood pressure medications that are safe during pregnancy.
- Pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) should be considered for safe blood pressure medications.
- Women should be screened for high blood pressure before starting birth control pills because the combination increases stroke risk. 女性不应该吸烟, and they should be aware that smoking while taking birth control pills increases the risk of stroke.
- Women smokers who have migraines with aura (visual impairments) should stop smoking to avoid a higher stroke risk.
- 75岁以上的妇女应进行房颤筛查. Women in this age group are more likely than men to develop the heart rhythm disorder, 哪一种会使中风的风险增加5倍.
科学证据表明这与子痫前期有关, gestational diabetes and other pregnancy complications with future cardiovascular disease is getting stronger, Chireau said. “The big concern I have as an obstetrician is that we’re seeing increasing rates of cardiovascular disease in younger women. 对女性来说，最重要的是了解她们的风险因素, 尤其是与怀孕有关的.”
From there, women can work with their primary care physicians to reduce their risks through dietary changes, 增加体力活动，必要时服用药物, Chireau said.
自2010年以来，“了解你的中风风险”一直是蒂亚·蒂姆普森的座右铭, when an undiscovered hole in the Maryland college student’s heart caused a blood clot to form and travel up to her brain.
“大多数女性都知道患乳腺癌和心脏病的风险. 但中风仍然有点隐蔽，”现年23岁的蒂姆普森说. “在我中风之前，我甚至不知道中风是什么，也不知道它是什么样子.”
布什内尔说，每个女性都应该向医生咨询中风的风险. “如果我们能帮助女性更多地了解中风和心血管风险, 他们可以在更早的年龄开始健康的生活. 这将在未来预防很多中风.”