More women over the age of 75 years have atrial fibrillation compared to men. Anticoagulation is effective in reducing stroke risk. Risk stratification tools, such as CHADS and CHADS-VASc, are useful for guiding clinicians in the decision to initiate anticoagulation therapy. New oral anticoagulants are efficacious alternatives to warfarin for stroke prevention, but research is needed to determine the appropriate dose in older women with a lower weight or women with comorbidities such as renal disease. Guidelines recommend the use of risk stratification tools for patients with atrial fibrillation that account for age and sex differences in the incidence of stroke. Primary care clinicians should actively screen women over the age of 75 years for atrial fibrillation using pulse taking followed by ECG as appropriate. New oral anticoagulants are recommended alternatives to warfarin in women with atrial fibrillation at increased stroke risk according to CHADS-VASc. Oral anticoagulation is not recommended for women age 65 years and younger who have atrial fibrillation without other stroke risk factors; antiplatelet therapy is a reasonable option for selected low-risk women. 4/28/23, 4:25 PM Stroke Prevention in Women: From Young Adulthood to Older Age - women with depression are at greatest risk for stroke. In clinical trials of primary and secondary stroke prevention, women need to be included in adequate numbers for preplanned subgroup analysis to examine sex differences. Additional research is needed to determine the benefits and risks of carotid procedures in women with asymptomatic high-grade stenosis and symptomatic moderate (50% to 69%) stenosis. Women with asymptomatic carotid stenosis should be assessed and treated for other stroke risk factors with lifestyle changes and medical therapies. The guidelines include several recommendations regarding the appropriate use of carotid endarterectomy. 