Ischemic stroke across sexes: What is the status quo?

Luca Liberale; Federico Carbone; Fabrizio Montecucco; Cathérine Gebhard; Thomas F Lüscher; Susanne Wegener; Giovanni G Camici

doi:10.1016/j.yfrne.2018.05.001

Ischemic stroke across sexes: What is the status quo?

Front Neuroendocrinol. 2018 Jul:50:3-17. doi: 10.1016/j.yfrne.2018.05.001. Epub 2018 May 16.

Authors

Luca Liberale¹, Federico Carbone², Fabrizio Montecucco³, Cathérine Gebhard⁴, Thomas F Lüscher⁵, Susanne Wegener⁶, Giovanni G Camici⁷

Affiliations

¹ Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, CH-8952 Schlieren, Switzerland; First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.
² First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.
³ First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; Ospedale Policlinico San Martino, 10 Largo Benzi, 16132 Genoa, Italy; Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132 Genoa, Italy.
⁴ Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, CH-8952 Schlieren, Switzerland; Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland.
⁵ Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, CH-8952 Schlieren, Switzerland; Cardiology, Royal Brompton and Harefield Hospitals and Imperial College, London, United Kingdom.
⁶ Department of Neurology, University Hospital Zurich and University of Zurich, Rämistrasse 100, CH-8091 Zürich, Switzerland.
⁷ Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, CH-8952 Schlieren, Switzerland. Electronic address: giovanni.camici@uzh.ch.

PMID: 29753797
DOI: 10.1016/j.yfrne.2018.05.001

Abstract

Stroke prevalence is expected to increase in the next decades due to the aging of the Western population. Ischemic stroke (IS) shows an age- and sex-dependent distribution in which men represent the most affected population within 65 years of age, being passed by post-menopausal women in older age groups. Furthermore, a sexual dimorphism concerning risk factors, presentation and treatment of IS has been widely recognized. In order to address these phenomena, a number of issue have been raised involving both socio-economical and biological factors. The latter can be either dependent on sex hormones or due to intrinsic factors. Although women have poorer outcomes and are more likely to die after a cerebrovascular event, they are still underrepresented in clinical trials and this is mirrored by the lack of sex-tailored therapies. A greater effort is needed in the future to ensure improved treatment and quality of life to both sexes.

Keywords: Estrogen; Gender; Ischemic stroke; Progesterone; Sex; Sex chromosomes; Sexual dimorphism; Testosterone.

Publication types

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

MeSH terms

Animals
Brain Ischemia* / epidemiology
Brain Ischemia* / physiopathology
Brain Ischemia* / prevention & control
Clinical Trials as Topic* / standards
Female
Gonadal Steroid Hormones* / metabolism
Humans
Male
Sex Characteristics*
Stroke* / epidemiology
Stroke* / physiopathology
Stroke* / prevention & control

Substances

Gonadal Steroid Hormones