Advocacy

In this project, ImmunoVation is taking an unconventional approach to try to understand why preeclamptic women form a blood clot. 

Working with a systems biology/machine learning approach, ImmunoVation seeks to pinpoint the most important elements that result in the increased chances of clot formation in preeclamptic women with the goal of developing treatments. 

Clinical guidelines are developed and published by the large physician organizations, in this case the American College of Gynecology (ACOG). 

ImmunoVation is working on providing patient chart review data and statistical analysis that allow ACOG to make recommendations especially for post-pregnancy monitoring of preeclamptic women. This does not exist to date resulting in a knowledge gap amongst physicians, nurses and care staff, and patients with sometimes dramatic consequences. 

  There are two types of strokes.

https://www.cdc.gov/stroke/about.htm

- Ischemic stroke

o The more common form

o A blood clots or particles block up a blood vessel in the brain.

- Hemorrhagic stroke

o Less common

o A blood vessel or an aneurism (bulge of a blood vessel) bursts in the brain and blood leaks out into the brain itself

These things increase your risk for a stroke.

https://www.cdc.gov/stroke/risk_factors.htm

- “mini-stroke” or transient ischemic attack

- High blood pressure 

- High cholesterol

- Some heart diseases

- Diabetes 

- Obesity

- Sickle cell disease

- Family history of stroke

- Higher age

- Stroke risk is higher in women than in men.

- Stroke risk is higher during pregnancy.

- Women who take birth control pills have a higher risk.

- Preeclampsia increases the risk of a stroke.

- Race or ethnicity People who are Black, Hispanic, American Indian, and Native Alaskan may be more likely to have a stroke than non-Hispanic Whites or Asians. The risk of having a first stroke is nearly twice as high for Blacks as for Whites. Blacks are also more likely to die from stroke than Whites are. 

These are the signs of a stroke.

https://www.cdc.gov/stroke/signs_symptoms.htm

- Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.

- Sudden confusion, trouble speaking, or difficulty understanding speech.

- Sudden trouble seeing in one or both eyes.

- Sudden trouble walking, dizziness, loss of balance, or lack of coordination.

- Sudden severe headache with no known cause.

Call 9-1-1 immediately if you or someone else has any of these symptoms. Every minute counts to prevent damage to the brain!

Stroke in women: 5th leading cause of death!

https://www.cdc.gov/stroke/women.htm

BUT 4 out of 5 strokes are preventable. 

The major factors are: 

- High blood pressure over 130/80. More than 2 in 5 women have blood pressure higher than that and that can lead to a stroke.

- Women live longer than men. The risk goes up with age.

- Why are African American women at higher risk? 

- Almost 3 in 5 African American women have 130/80 or higher blood pressure: much more than white women.

- Higher rate of obesity (~3 in 5 African American women)

-1 in 8 African American women have diabetes.

- Sickle cell disease is more common in African Americans than in the general population.

- Smoking is a risk factor for stroke and is more common in African American women.

How can I prevent stroke? 

- Speak with your doctor!

- You may want to take low dose aspirin. Some types of stroke can get worse on aspirin so speak to your doctor first. 

- Control your blood pressure with medication and lifestyle changes. 

- Manage your cholesterol with medication and lifestyle changes. 

- Try to quit smoking! 

We want you to live happy and healthy. Any changes you make to your lifestyle help! Take that little walk, eat an apple instead of fries. Build healthy habits for yourself and your loved ones. They want you around!

Pregnancy and stroke

https://www.cdc.gov/stroke/pregnancy.htm

- Having high blood pressure during pregnancy is the leading cause of stroke in pregnant women or women who recently gave birth.

- About 12% of women develop high blood pressure during their pregnancy.

- Having had high blood pressure also increases your risk of stroke AFTER pregnancy.

- Preeclampsia, a disease where the blood pressure is high for extended periods of time, puts you at high risk for heart attack and stroke during and after pregnancy. 

- Of the women who died in California of preeclampsia between 2002 to 2007, over half died of a stroke. All of them showed typical signs of the disease, had blood pressure of 160 or higher over 110 or higher, 87% had headache as a typical sign. Delayed response to clinical warning signs was seen in 91% of cases and ineffective treatment in 76% of cases contributed to the death of the women. In other words, the people around the women didn’t recognize what was happening. When they arrived at the hospital, they also didn’t receive the treatment they needed. https://pubmed.ncbi.nlm.nih.gov/31135728/

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Below is a link to the CDC definition of heart attack.  

https://www.cdc.gov/heartdisease/heart_attack.htm

Heart disease is the leading cause of death in the US!

The most common type of heart disease is Coronary Artery Disease which leads to Heart attack.

While we think of heart disease as a man’s disease, almost as many women die from it as men in the US. 

Every 40 seconds someone in the US has a heart attack. 

About 1 in 5 heart attacks are silent: the damage is done but the person is not aware of it. 

The risks for heart disease are:

- High blood pressure

- High blood cholesterol

- Smoking

- Diabetes

- Being overweight or obese

- Unhealthy diet

- Physical inactivity

- Excessive alcohol use

The major symptoms of a heart attacks are:

• Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes or that goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
• Feeling weak, light-headed or faint. You may also break out into a cold sweat.
• Pain or discomfort in the jaw, neck or back.
• Pain or discomfort in one or both arms or shoulders.
• Shortness of breath. This often comes along with chest discomfort, but shortness of breath also can happen before chest discomfort.

Specifically for women, heart disease is the leading cause of death.

https://www.cdc.gov/heartdisease/women.htm

https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women

What are the symptoms of an acute heart attack in women?

Although some women have no symptoms, others may have:

• Angina (dull and heavy or sharp chest pain or discomfort). Lasts more than a few minutes. May go away and come back. 
• Breaking out in a cold sweat, nausea, or lightheadedness.
• Pain in one or both arms, back, neck, or stomach.
• Pain in the upper abdomen or back.

These symptoms may happen when you are resting or when you are doing regular daily activities. 

Women, in contrast to men, are more likely to experience some of the other common symptoms, especially:

• Nausea
• Vomiting
• Fatigue
• Back or jaw pain
• Lightheadedness or fainting
• Shortness of breath
• Some women say: “I thought I had the flu”, or “I thought I had acid reflux.”

If you have any of these symptoms, call 9-1-1 right away.

If you had preeclampsia or any period of high blood pressure during your pregnancy, you are at higher risk of experiencing a heart attack. So if you feel any of these symptoms, call 9-1-1 right away and get help! Don’t wait.