AHA/ASA guideline recommendations for prevention of stroke in women risk factors: Difference between revisions
m (Bot: Adding CME Category::Cardiology) |
|||
(One intermediate revision by one other user not shown) | |||
Line 25: | Line 25: | ||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki> Severe hypertension in pregnancy should be treated with safe and effective antihypertensive medications, such as methyldopa, labetalol, and nifedipine, with consideration of maternal and fetal side effects. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''. <nowiki>"</nowiki> | ||
|} | |} | ||
Line 32: | Line 32: | ||
|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm) | |colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm) | ||
|- | |- | ||
|bgcolor="LightCoral"|<nowiki>"</nowiki> | |bgcolor="LightCoral"|<nowiki>"</nowiki> Atenolol, angiotensin receptor blockers, and direct renin inhibitors are contraindicated in pregnancy and should not be used. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
Line 42: | Line 42: | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' After giving birth, women with chronic hypertension should be continued on their antihypertensive regimen, with dosage adjustments to reflect the decrease in volume of distribution and glomerular filtration rate that occurs after delivery. They should also be monitored carefully for the development of postpartum preeclampsia. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' After giving birth, women with chronic hypertension should be continued on their antihypertensive regimen, with dosage adjustments to reflect the decrease in volume of distribution and glomerular filtration rate that occurs after delivery. They should also be monitored carefully for the development of postpartum preeclampsia. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |||
===Prevention of Stroke in a Woman with a History of Preeclampsia=== | |||
{|class="wikitable" style="width:80%" | |||
|- | |||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] | |||
|- | |||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki> Because of the increased risk of future hypertension and stroke 1 to 30 years after delivery in women with a history of preeclampsia ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'', it is reasonable to:<nowiki>"</nowiki> | |||
|- | |||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Consider evaluating all women starting 6 months to 1 year post partum, as well as those who are past childbearing age, for a history of preeclampsia/eclampsia and document their history of preeclampsia/eclampsia as a risk factor, and | |||
'''2'''. Evaluate and treat for cardiovascular risk factors including hypertension, obesity, smoking, and dyslipidemia ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|} | |} | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WS}} | |||
{{WH}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Aging-associated diseases]] | [[Category:Aging-associated diseases]] | ||
Line 58: | Line 73: | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
Latest revision as of 19:39, 14 March 2016
Stroke Main page | |
Diagnosis | |
---|---|
Treatment | |
Case Studies | |
AHA/ASA guideline recommendations for prevention of stroke in women risk factors On the Web | |
American Roentgen Ray Society Images of AHA/ASA guideline recommendations for prevention of stroke in women risk factors | |
FDA on AHA/ASA guideline recommendations for prevention of stroke in women risk factors | |
CDC on AHA/ASA guideline recommendations for prevention of stroke in women risk factors | |
AHA/ASA guideline recommendations for prevention of stroke in women risk factors in the news | |
Blogs on AHA/ASA guideline recommendations for prevention of stroke in women risk factors | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]
Overview
Sex-Specific Risk Factors
Risk Factors Commoner in Women
2014 AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (DO NOT EDIT)
Prevention of Preeclampsia
Class I |
"1. Women with chronic primary or secondary hypertension or previous pregnancy-related hypertension should take low-dose aspirin from the 12th week of gestation until delivery. (Level of Evidence: A). " |
"2. Calcium supplementation (of ≥1 g/d, orally) should be considered for women with low dietary intake of calcium (<600 mg/d) to prevent preeclampsia. (Level of Evidence: A). " |
Treatment of Hypertension in Pregnancy and Post Partum
Class I |
" Severe hypertension in pregnancy should be treated with safe and effective antihypertensive medications, such as methyldopa, labetalol, and nifedipine, with consideration of maternal and fetal side effects. (Level of Evidence: A). " |
Class III (Harm) |
" Atenolol, angiotensin receptor blockers, and direct renin inhibitors are contraindicated in pregnancy and should not be used. (Level of Evidence: C) " |
Class IIa |
"1. Consideration may be given to treatment of moderate hypertension in pregnancy with safe and effective antihypertensive medications, given the evidence for possibly increased stroke risk at currently defined systolic and diastolic BP cutoffs, as well as evidence for decreased risk for the development of severe hypertension with treatment (although maternal-fetal risk-benefit ratios have not been established)(Level of Evidence: B)" |
"2. After giving birth, women with chronic hypertension should be continued on their antihypertensive regimen, with dosage adjustments to reflect the decrease in volume of distribution and glomerular filtration rate that occurs after delivery. They should also be monitored carefully for the development of postpartum preeclampsia. (Level of Evidence: C)" |
Prevention of Stroke in a Woman with a History of Preeclampsia
Class IIa |
" Because of the increased risk of future hypertension and stroke 1 to 30 years after delivery in women with a history of preeclampsia (Level of Evidence: B), it is reasonable to:" |
"1. Consider evaluating all women starting 6 months to 1 year post partum, as well as those who are past childbearing age, for a history of preeclampsia/eclampsia and document their history of preeclampsia/eclampsia as a risk factor, and
2. Evaluate and treat for cardiovascular risk factors including hypertension, obesity, smoking, and dyslipidemia (Level of Evidence: C)" |