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Women Have Worse Stroke Outcomes than Men

Stroke continues to be a leading cause of death and disability worldwide, with women being more adversely affected by the condition globally.

This is according to Dr. Ralph Sacco, a past president of the American Heart Association, who adds that as the population ages, the number of stroke survivors will continue to rise, especially among women.

Sacco’s comments stem from research finding published in the latest issue of Stroke, which saw its researchers select nine manuscripts focused on stroke disparities in women.

The research indicates that worldwide, stroke is the second leading cause of death with more than 101 million people having a stroke each year, and more than 6.6 million people dying of a stroke, annually. It further indicates that about 1 in 4 stroke survivors will experience another stroke within five years.

The publication features international studies and perspectives from more than half a dozen countries.

Of the studies chosen, two addressed concerns about the lack of women particpants in stroke clinical trials, thus limiting information to ensure appropriate stroke treatment for women, which has long been an issue for scientists.

One of the studies dubbed Sex, Age, and Socioeconomic Differences in Non-fatal Stroke Incidence and Subsequent Major Adverse Outcomes by Ralph K. Akyea et al. found that the rate of stroke incidence among people ranked in the lowest ranking of socioeconomic status was 10 percent higher than the rate in the highest socioeconomic status rank. Those rankings were based on factors such as income, employment, education, skills and training, health and disability, crime, barriers to housing and services, and living environment.

From a subset of 68,877 stroke survivors who had not had previous complications, the study found several pointers, among them, 47,500 eventually had a major adverse cardiovascular event of which 25,731 were women; 33,831 had another stroke with 52 percent of them being women.

It also found that 20,335 people died of any cause, with 59 percent being women, while 9,174 died of cardiovascular complications with more than 61 percent being women.

“The researchers noted their findings show a higher burden of major adverse outcomes (such as a cardiovascular event, stroke, or death) observed in women when compared to men after first non-fatal stroke is largely accounted for by age and socioeconomic status,” the published findings say.

Another study dubbed, Advances in Stroke: Stroke in Women by Moira K. Kapral et al. identified numerous instances of women having worse stroke outcomes than men – and women had higher rates of death, disability, and quality of life, much of which can be attributed to age, stroke severity, pre-stroke function capacity and depression.

The researchers suggest targets for interventions which could include efforts to reduce stroke severity (e.g., through the management of stroke risk factors), address mood disorders (e.g., through routine screening and treatment) and optimize functional status and quality of life (e.g., through rehabilitation).

They also analyzed findings from the California Teachers Study that found the risk of stroke before age 60 was modified by aspirin use in women with hypertensive disorders of pregnancy. Women who did not use aspirin had an increased risk of stroke, while those on aspirin therapy did not.

The authors noted the fact that aspirin can prevent preeclampsia when taken during pregnancy suggests an interesting link for aspirin use, hypertensive disorders of pregnancy and ischemic stroke risk beyond child-bearing years.

According to the publication, these findings are consistent with prior studies that have identified hypertensive disorders of pregnancy as a risk factor for subsequent stroke, and the authors suggest that aspirin could be a target for future controlled trials for stroke prevention.

The team led by Dr. Sacco has called for the inclusion of more women in stroke research so that there can be an enhancement of the critical evidence necessary to provide the appropriate stroke treatments needed to save and improve lives.

Author: Margaret Njuguna

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