Women with preeclampsia prone to stroke, Aspirin lowers the risk

According to a new study led by researchers at Columbia University Vagelos College of Physicians & Surgeons, Middle-aged women with a history of preeclampsia have a greater risk of stroke, and aspirin may be able to reduce the risk. The study was published in the journal Neurology.

Low-dose aspirin treatment during pregnancy decreases the incidence of preeclampsia among high-risk women, but most women stop taking aspirin after delivery. It is unknown whether aspirin use after delivery offers long-term benefits.

Preeclampsia increases the long-term risk of cardiovascular disease, including stroke, a leading cause of disability and death in women. Although younger stroke patients are usually less impaired by a stroke in the short term than older patients, years of disability and loss of income can have severe long-term consequences.

The researchers used data from 84,000 women enrolled in the California Teachers Study; of these, roughly 4,000 had a history of preeclampsia. Women were considered regular aspirin users if they reported taking aspirin three or more times a week after delivery for at least one year.

The researchers found that the overall stroke risk was 30 per cent higher in women with a history of preeclampsia, compared to those with no history.

Regular aspirin use seemed to erase the increased risk of stroke associated with preeclampsia, but only in women under 60. Aspirin users in this age group with a history of preeclampsia had the same stroke risk as women with no history of the condition. In comparison, formerly preeclamptic women in this age group who did not take aspirin had a 50 per cent greater risk of stroke. Aspirin use had no significant effect on reducing excess stroke risk in women over 60 with a history of preeclampsia.

"It would be premature, at this point, to recommend aspirin for all women with a history of preeclampsia, since aspirin can have serious side effects, such as bleeding that leads to hospitalization," says lead author Eliza C. Miller, MD, a neurologist at Columbia University Irving Medical Center.

But Miller says that aspirin may be warranted for some of these women. Many organizations currently recommend low-dose aspirin to prevent heart attack and stroke for some people at high risk of cardiovascular disease.

"A history of preeclampsia is currently not considered when calculating 10-year cardiovascular risk, but it probably needs to be incorporated into risk-estimation guidelines," Miller says. "Some women with this history may need primary preventive treatment with aspirin, even in the absence of additional vascular risk factors."