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Almost 4 million American women could tell you just what a stroke feels like-they've survived one. But one in five women in the general population can't name a single warning sign, a new survey finds. Now, a new effort by health experts aims to slash stroke rates among women. The strategy: Reduce risk factors only females face.

"Women and men share some of the same risk factors for stroke, such as smoking, high cholesterol and high blood pressure," said Lourdes cardiologist Rozy Dunham, MD, FACC. "But women have their own set of gender-related risk factors linked to hormonal shifts, pregnancy and childbirth."

Women Face Special Dangers

A stroke occurs when the blood flow that nourishes the brain is reduced or stopped, or when there is bleeding into the brain. Although heart attacks get more press, strokes rank as the third-leading cause of death among women. More than 400,000 U.S. women each year have one, and more than 75,000 die. Strokes kill twice as many women each year as breast cancer.

As in men, smoking, extra weight and high blood pressure increase your risk. But new guidelines from the American Heart Association and American Stroke Association address factors unique to women, including:

  • Pregnancy. Natural changes in the body such as increased blood pressure and stress on the heart heighten stroke risk.
  • Preeclampsia. This blood-pressure disorder during pregnancy doubles new moms' stroke risk. Women with high blood pressure before pregnancy might need aspirin or other drugs to reduce it. And women who develop preeclampsia should be watched closely for strokes later in life.
  • Migraine headaches with aura. Women who suffer these hard-hitting headaches can be up to six times more likely to suffer a stroke.
  • Atrial fibrillation. This irregular heartbeat leads to four-to-five times the stroke risk among older women. Those aged 75 and older should be examined for it, and treated if necessary.
  • Metabolic syndrome, a group of risk factors that increase your likelihood for developing heart disease and diabetes. These include a large waistline, low HDL (good) cholesterol, high triglycerides, high blood pressure and high fasting blood sugar.
  • Depression and emotional stress

Taking birth control pills or hormone replacement therapy to relieve menopausal symptoms also can affect stroke risk.

Raising Visibility

Earlier this year, the American Heart Association published new guidelines to make women and their doctors more aware of their stroke risk. These guidelines include:

  • Before taking birth control pills, women should be screened for high blood pressure.
  • Women who suffer from migraine headaches with aura should stop smoking to reduce stroke risk.
  • Preeclampsia should be seen as a risk factor long after pregnancy, since women with the condition have twice the risk of stroke and four times the risk of high blood pressure later in life.
  • Pregnant women with severe high blood pressure (160/110 mmHg or above) should be treated with medication.
  • Expectant mothers with moderate high blood pressure (150-159 mmHg/100-109 mmHg) should be considered for treatment.

Act F.A.S.T. When Symptoms Strike

Eventually, doctors hope to develop a risk score to help women understand their chances of having a stroke. In the meantime, you can take action by learning the warning signs. Remember the acronym F.A.S.T.:

  • Face drooping. Look for an uneven smile.
  • Arm weakness. One arm may feel numb or feeble.
  • Speech difficulty. Listen for slurring, garbling or trouble talking at all.
  • Time to call 911. Dial if any of these symptoms appear in you or a loved one. If it is a stroke, swift treatment can make a big difference.

"Knowing these risks-and stroke warning signs-could help reduce your chances of becoming the next victim," said Dr. Dunham.

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