LOS ANGELES – Women with a history of preeclampsia have a significantly increased risk for an early-onset stroke, but that risk is blunted in women taking aspirin, an epidemiologic analysis of data from more than 83,000 women in the California Teachers Study showed.
Among the 4,072 women in the study with a history of preeclampsia, 3,003 were not on aspirin, and during follow-up they had a greater than 1% incidence of stroke – ischemic and hemorrhagic combined – before turning 60 years of age. Their incidence rate was 40% higher than in the roughly 60,000 women without a preeclampsia history who were not taking aspirin, a statistically significant difference after adjustment for demographics, smoking, obesity, diabetes, and hypertension,, said at the International Stroke Conference, sponsored by the American Heart Association.
Her analysis used data drawn from more than 133,000 women enrolled starting in 1995 in the California Teachers. She focused on 83,790 women who entered the study when they were younger than 60 years old, who had no history of stroke, and who provided data on their history of preeclampsia. The prevalence of a preeclampsia history was 4.9% overall, and 6.1% among women who had been pregnant at least once, an incidence rate similar to what has been found in other large populations of women, Dr. Miller said.
The average age of the women with preeclampsia was 44, and 46 for those without preeclampsia. The women with a history of preeclampsia also had a higher prevalence rate of obesity, hypertension, diabetes, and chronic kidney disease. Roughly a quarter of all women were regularly taking aspirin.
After adjustment of the data for demographic and clinical differences, women with a history of preeclampsia had a 20% higher overall rate of a subsequent stroke before reaching age 60 years, but this difference was not significant in an analysis that included both women taking aspirin and those not on the drug. When the analysis focused only on the women not on aspirin, the increased stroke rate linked with a preeclampsia history rose to 40% higher than in women without a preeclampsia history, a statistically significant difference. In contrast, among the quarter of women on aspirin, the two subgroups – with a preeclampsia history and without – had similar rates of incident strokes.
SOURCE: Miller E et al. International Stroke Conference 2018, A174 (Stroke. 2018 Jan; ).