Stroke in women
Keywords:
epidemiology, prevention, risk factors, sex differences, strokeAbstract
Stroke is a a leading cause of death and severe, long-term disability. Because of their longer lifespan, women have a higher stroke burden than men, especially in the age ≥ 85 years. Data from the Framingham Study suggested that 1 in 5 women and 1 in 6 men reaching the age of 55 years free of stroke will develop a stroke event during their remaining lifetime. Ischemic stroke accounts for 87% of all stroke cases and cardioembolic stroke is significantly more common in women. Women exhibit more severe post-stroke disability, depression and dementia, resulting in more frequent use of institutional care. There are gender differences in the primary and secondary prevention of stroke.
References
Kalevska E. Intravenous thrombolysis in ischemic stroke - clinical aspects and correlations. Abstract of the Dissertation for the degree of "Doctor of Medicine". Medical University Varna. 2016
Maslarov D, Mitsova O. Perspectives of personalized medicine in stroke. Bulgarian Neurology. 2014, 15, 1: 6-11.
Milanov Iv. Prevention of cerebrovascular diseases. Bulgarian Neurology. 2015, 16, 1: 1-4.
Milanov Iv., Stamenova P. National Consensus for prevention, diagnosis, treatment and rehabilitation of cerebrovascular diseases. Bulgarian Neurology. 2013, 14, 3-1: 170-189.
Nikolov P. Therapeutic approach in prehypertension. XIV National Congress of Cardiology, October 2-5, 2014, Varna.
Peeva K., Marinova Yu., Veleva G., Dimitrova Sv., Mineva M. Dynamics of mortality from cerebrovascular diseases - a comparative analysis for Bulgaria and Europe, Collection of reports "Prevention of socially significant diseases", Pro otology, Supplement: 8, 2003, 78-80.
Tityanova E., Velcheva I., Andonova S. Stroke in Bulgaria: contemporary problems. Neurosonology and Brain Hemodynamics. 2015, 11, 1: 7-13.
Hristov V., Gocheva N., Petkova M., Zaharieva S., Tankova Tsv., Orbetsova M., Katova Tsv., Georgiev B. on behalf of the Working Group at BIMS. Consensus of the Bulgarian Institute "Metabolic Syndrome" for behavior in metabolic syndrome. Science Endocrinology 2. 2010, 53-70.
Al-hussain F., Hussain M.S., Molina C., Uchino K., Shuaib A., Demchuk A.M., Alexandrov A.V., Saqqur M., CLOTBUST Investigators. Does the sex of acute stroke patients influence the effectiveness of rt-PA? BMC Neurol. 2014, 14:60.
Appelros P., Stegmayr B., Tere´nt A. Sex Differences in Stroke Epidemiology. A Systematic Review. Stroke. 2009, 40:1082-1090.
Arboix A., Blanco-Rojas L., Oliveres M., García-Eroles L., Comes E., Massons J. Clinical characteristics of acute lacunar stroke in women: emphasis on gender differences. Acta Neurol Belg. 2014, 114(2):107-12.
Bigal M.E., Kurth T., Santanello N., Buse D., Golden W., Robbins M., Lipton R.B. Migraine and cardiovascular disease: a population-based study. Neurology. 2010, 74:628–35.
Bombeli T., Basic A., Fehr J. Prevalence of hereditary thrombophilia in patients with thrombosis in different venous systems. Am J Hematol. 2002, 70:126-132.
Bushnell C., McCullough L.D., Awad I.A., Chireau M.V., Fedder W.N., Furie K.L., Howard V.J., Lichtman J.H., Lisabeth L.D., Piña I.L., Reeves M.J., Rexrode K.M., Saposnik G., Singh V., Towfighi A., Vaccarino V., Walters M.R.; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Council for High Blood Pressure Research. Guidelines for the Prevention of Stroke in Women: a Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014, 45(5):1545-88.
Dehlendorff C.; Andersen K.K., Olsen T.S. Sex Disparities in Stroke: Women Have More Severe Strokes but Better Survival Than Men. J Am Heart Assoc. 2015, 4: e001967.
Dentali F., Crowther M., Ageno W. Thrombophilic abnormalities, oral contraceptives, and risk of cerebral vein thrombosis: a meta-analysis. Blood. 2006, 107:2766-2773.
Emdin C.A., Wong C.X., Hsiao A.J., Altman D.G., Peters S.A.E., Woodward M., Odutayo A.A. Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies BMJ. 2016; 352 :h7013.
Eurostat. Available at: http://ec.europa.eu/eurostat/statistics-explained/index.php/ Causes_of_death_statistics/bg.
Ferro J.M., Canha˜o P., Stam J., Bousser M.G., Barinagarrementeria F; ISCVT Investigators. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004, 35:664–670.
Förster A., Gass A., Kern R., Wolf M.E., Ottomeyer C., Zohsel K., Hennerici M., Szabo K. Gender Differences in Acute Ischemic Stroke: Etiology, Stroke Patterns and Response to Thrombolysis. Stroke. 2009, 40:2428-2432.
Ghods A.J., Lopes D., Chen M. Gender differences in cerebral aneurysm location. Front Neurol. 2012, 3:78.
Hier D.B., Yoon W.B., Mohr J.P., Price T.R., Wolf P.A. Gender and aphasia in the Stroke Data Bank. Brain Lang. 1994, 47:155-67.
Hill M.D., Kent D.M., Hinchey J., Rowley H., Buchan A.M., Wechsler L.R., Higashida R.T., Fischbein N.J., Dillon W.P., Gent M., Firszt C.M., Schulz G.A., Furlan A.J.; PROACT-2 Investigators. Sex-based differences in the effect of intra-arterial treatment of stroke: analysis of the PROACT-2 study. Stroke. 2006, 37(9):2322-5.
Hsia J., Margolis K.L., Eaton C.B., Wenger N.K., Allison M., Wu L., LaCroix A.Z., Black H.R.; Women’s Health Initiative Investigators. Prehypertension and cardiovascular disease risk in the Women’s Health Initiative. Circulation. 2007, 115:855–860.
Jørgensen HS, Weber U, Nakayama H, Kammersgaar LP, Olsen TS. Differences in risk factor distribution, initial stroke severity, and outcome in men and women. The Copenhagen Stroke Study. Cerebrovasc Dis. 1999, 9:19.
Kapral M.K., Fang J., Hill M.D., Silver F., Richards J., Jaigobin C., et al. Sex differences in stroke care and outcomes: results from the Registry of the Canadian Stroke Network. Stroke. 2005, 36:809-14.
Kelly-Hayes M., Beiser A., Kase C.S., Scaramucci A., D’Agostino R.B., Wolf P.A. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003, 12:119-126.
Lane D.A., Grant P.J. Role of hemostatic gene polymorphisms in venous and arterial thrombotic disease. Blood. 2000, 2:1517-1532.
Lasek-Bal A., Szymszal J., Kazibutowska Z. Stroke Risk Factors, Course and Long-Term Functional Outcome of First-Ever Stroke in Women. OA Maced J Med Sci. 2014, 2(1):119-123.
Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CW, Keiding NN. Thrombotic stroke and myocardial infarction with hormonal contraception. Engl J Med. 2012, 366:2257-66.
Lisabeth L.D., Beiser A.S., Brown D.L., Murabito J.M., Kelly-Hayes M, Wolf P.A. Age at natural menopause and risk of ischemic stroke: the Framingham heart study. Stroke. 2009, 40(4):1044-9.
Lisabeth L.D., Brown D.L., Hughes R., Majersik J.J., Morgenstern L.B. Acute Stroke Symptoms. Comparing Women and Men. Stroke. 2009, 40:2031-2036.
Lundberg G.P., Volgman A.S. Burden of stroke in women. Trends Cardiovasc Med. 2016, 26(1):81-8.
Mhurchu C.N., Anderson C., Jamrozik K., Hankey G., Dunbabin D. Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS) Group. Hormonal factors and risk of aneurysmal subarachnoid hemorrhage: an international population-based, case-control study. Stroke. 2001, 32:606-612.
O’Donnell M.J., Xavier D., Liu L., Zhang H., Chin S.L., Rao-Melacini P., Rangarajan S., Islam S., Pais P., McQueen M.J., Mondo C., Damasceno A., Lopez-Jaramillo P., Hankey G.J., Dans A.L., Yusoff K., Truelsen T., Diener H.C., Sacco R.L., Ryglewicz D., Czlonkowska A., Weimar C., Wang X., Yusuf S. INTERSTROKE Investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010, 376:112–123.
Persky R.W., Turtzo L.C., McCullough L.D. Stroke in Women: Disparities and Outcomes. Curr Cardiol Rep. 2010, 12(1):6-13.
Piccini J.P., Fraulo E.S., Ansell J.E., Fonarow G.C., Gersh B.J., Go A.S., Hylek E.M., Kowey P.R., Mahaffey K.W., Thomas L.E., Kong M.H., Lopes R.D., Mills R.M., Peterson E.D. Outcomes registry for better informed treatment of atrial fibrillation: rationale and design of ORBIT-AF. Am Heart J. 2011, 162(4):606-612.e1.
Reid J.M. Gender differences in stroke examined in a 10-year cohort of patients admitted to a Canadian teaching hospital. Stroke. 2008, 39:1090-5.
Roquer J., Campello A.R., Gomis M. Sex differences in first-ever acute stroke. Stroke. 2003, 34:1581-5.
Santalucia P., Pezzella F.R., Sessa M., Monaco S., Torgano G., Anticoli S., Zanoli E., Maimone Baronello M., Paciaroni M., Caso V. Women Stroke Association (WSA). Sex differences in clinical presentation, severity and outcome of stroke: results from a hospital-based registry. Eur J Intern Med. 2013, 24(2):167-71.
Saposnik G., Barinagarrementeria F., Brown R.D.Jr, Bushnell C.D., Cucchiara B., Cushman M., deVeber G., Ferro J.M, Tsai F.Y. Diagnosis and Management of Cerebral Venous Thrombosis: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011, 42:1158-1192.
Seshadri S., Beiser A., Kelly-Hayes M., Kase C.S., Au R., Kannel W.B., Wolf P.A. The lifetime risk of stroke: estimates from the Framingham Study. Stroke. 2006, 37:345–350.
Shinton R., Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989, 298(6676):789-794.
Shobha N., Sylaja P.N., Kapral M.K., Fang J., Hill M.D. Investigators of the Registry of the Canadian Stroke Network. Differences in stroke outcome based on sex. Neurology. 2010, 74(9):767-71.
Steinberg B.A., Blanco R.G., Ollis D., Kim S., Holmes D.N., Kowey P.R., Fonarow G.C., Ansell J., Gersh B., Go A.S., Hylek E., Mahaffey K.W., Thomas L., Chang P., Peterson E.D., Piccini J.P. ORBIT-AF Steering Committee Investigators. Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II: rationale and design of the ORBIT-AF II registry. Am Heart J. 2014, 168(2):160-7.
Watila M.M., Nyandaiti Y.W., Bwala S.A., Ibrahim A. Gender variation in risk factors and clinical presentation of acute stroke, Northeastern Nigeria. Journal of Neuroscience and Behavioural Health. 2011, 3(3):38-43.
Zhang X., Sun Z., Zhang X., Zheng L., Liu S., Xu C., Li J., Zhao F., Li J., Hu D., Sun Y. Gender differences in blood lipids and the risk of ischemic stroke among the hypertensive adults in rural China. Neurol India. 2007, 55(4):338-42.
Published
How to Cite
Issue
Section
License
Copyright (c) 2016 Dimitar Maslarov, D. Drenska

This work is licensed under a Creative Commons Attribution 4.0 International License.