Sex matters in stroke: A review of recent evidence on the differences between women and men

Cheryl Carcel; Mark Woodward; Xia Wang; Cheryl Bushnell; Else Charlotte Sandset

doi:10.1016/j.yfrne.2020.100870

Sex matters in stroke: A review of recent evidence on the differences between women and men

Front Neuroendocrinol. 2020 Oct:59:100870. doi: 10.1016/j.yfrne.2020.100870. Epub 2020 Sep 1.

Authors

Cheryl Carcel¹, Mark Woodward², Xia Wang³, Cheryl Bushnell⁴, Else Charlotte Sandset⁵

Affiliations

¹ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; The University of Sydney, Sydney School of Public Health, Sydney Medical School, New South Wales, Australia. Electronic address: ccarcel@georgeinstitute.org.au.
² The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; The George Institute for Global Health, University of Oxford, Oxford, UK; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
³ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁴ Wake Forest School of Medicine, Winston Salem, NC, USA.
⁵ Department of Neurology, Oslo University Hospital, Oslo, Norway; Department of Research and Development, The Norwegian Air Ambulance Foundation, Oslo, Norway.

PMID: 32882229
DOI: 10.1016/j.yfrne.2020.100870

Abstract

For the most part, stroke is a disease of old age. With the predicted increase in the aged population and longer life expectancies, the number and proportion of people living with stroke is expected to increase, especially among women and the elderly. For those who suffer stroke, there is a high likelihood of experiencing death and severe disability. Therefore, the issue of stroke amongst women (and men) is a key priority in global public health. In this review, we consider sex and gender differences in ischemic and hemorrhagic stroke, and we summarize data that outlines the epidemiology, risk factor, treatment recovery and prevention of stroke. We discuss possible mechanisms for the sex differences, specifically in areas of biology, medical management and social and behavioral context. With evidence showing that women and men experience stroke differently, sex must be taken into account when treating patients and when designing clinical trials.

Keywords: Gender; Intracerebral hemorrhage; Ischemic stroke; Sex; Sex differences; Stroke.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Clinical Trials as Topic
Female
Hemorrhagic Stroke / diagnosis*
Humans
Ischemic Stroke / diagnosis*
Male
Severity of Illness Index
Sex Factors