Chapter 27 - Hypertension and stroke

Summary

Many women have hypertension and this is the most common and important risk factor for stroke. This chapter presents the diagnosis, evaluation, and primary and secondary prevention and treatment of hypertension and stroke. With a diagnosis of hypertension, a complete evaluation for other risk factors for heart disease including diabetes and hyperlipidemia is important. Multiparous women who develop pregnancy induced hypertension or pre-eclampsia (PE) are six to seven times more likely to become hypertensive in later life. Regular alcohol use increases the risk of hypertension and stroke. One out of three women who have transient ischemic attack (TIA) will have a stroke within five years, and one out of five within one month. Although the risk of stroke is very low in women of childbearing age, use of oral contraceptive pills does increase the risk, especially if the woman has coexistent hypertension, is older than 35 and/or smokes.