DALLAS -- Every time Lorena Gonzales gets her unborn baby checked, she is also screened for heart disease and stroke with a blood pressure test.

She didn't realize that.

'When I think about it, I thought he's just checking that the baby's OK,' Gonzales said. 'And as long as the baby's OK, everything's good.'

New screening guidelines from the American Heart Association put OB-GYNs on the front line of stroke prevention.

'We know that women at certain times of her life are at higher risk,' explained Texas Health Dallas ob-gyn Dr. Jay Staub. 'So we watch them carefully, we check their blood pressures routinely - particularly during pregnancy - we're aware of hypertension issues during pregnancy, and we watch them when they're on birth control pills because those are really the two areas where they're at greatest risk.'

Stroke is the fifth-leading cause of death in men and the third for women. A stroke occurs when a blood vessel to the brain is blocked by a clot or bursts.

Men and women share risk factors for stroke, including high blood pressure, high cholesterol, and smoking. According to the American Heart Association, about 55,000 more women than men experience a stroke. Hormones put women at particular risk.

Among the screening recommendations:

  • Women should be checked for high blood pressure before starting oral contraceptives.
  • Women with a history of high blood pressure before or during pregnancy be evaluated for medication
  • Women with migraine headaches with aura should stop smoking, if they are taking birth control
  • Women over 75 should be screened for atrial fibrillation risks

The guidelines are aimed a physicians women see on an annual basis, including family practice physicians. For many women, an ob-gyn is the only doctor they see on a regular basis. Dr. Staub worries that confusing messages about how often women need pap smears might prevent many from getting the bonus screening for stroke.

'Rather than associate the annual exam with the pap smear, there's other things that we do,' he said. 'And among them is a blood pressure check and it's very important to be screened and get the basis -- whether you're getting a pap smear or not, whether you're on the pill or not.'


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