Impact of Conventional Stroke Risk Factors on Stroke in Women
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Stroke is a disease that affects all populations, but women bear a greater disease burden compared with men. Because of increasing stroke risk with age and a longer life expectancy, women experience more strokes and more death from stroke over the lifetime.1,2 In addition, recent data show that age-adjusted stroke risk in women may not be declining to the same extent that it is in men, potentially resulting in similar age-adjusted stroke incidence rates between the sexes.3 Finally, women have worse functional outcomes after stroke,2 adding to the negative impact that stroke has on women.
Optimizing stroke prevention in women is critical to reducing the number of strokes, the personal and societal costs of long-term disability from stroke, and stroke deaths. In 2014, guidelines published by the American Heart Association and American Stroke Association highlighted aspects of stroke prevention that should be tailored for women.4 The objective of this article is to summarize recent evidence on stroke risk factors in women and to identify possible sex differences in these risk factors. We aim to review current literature (2013 to present) to determine whether (1) there are sex differences in the prevalence of key risk factors for ischemic stroke; (2) there is a sex difference in the strength of associations between key risk factors and ischemic stroke; and (3) there is evidence for disparities in treatment or control of stroke risk factors between women and men. We chose to focus on ischemic stroke because the risk factors and pathophysiology differ from those relevant to hemorrhagic stroke. Risk factors included in the current review include hypertension, atrial fibrillation (AF), dyslipidemia, diabetes mellitus, migraine, and cognitive impairment.
This article was designed as a narrative review. Pubmed was searched using the following terms: women, sex differences, or gender …