The impact of sex on stroke care: From epidemiology to outcome

J Stroke Cerebrovasc Dis. 2024 May;33(5):107675. doi: 10.1016/j.jstrokecerebrovasdis.2024.107675. Epub 2024 Mar 11.

Abstract

Background: Carotid stenosis and atrial fibrillation are key risk factors for development of hemispheric strokes. In this review we aim to identify sex-specific differences in the pathophysiology and treatment of these risk factors and areas for future study.

Key findings: Women are underrepresented in research studies of stroke in patients with carotid disease and atrial fibrillation. However, key differences have been found between men and women that suggest that the development of carotid disease and atrial fibrillation occur at later stages of life and are associated with higher severity of stroke. Some treatments, including surgical treatment, seem to have different rates of efficacy and women and women are at higher risk of surgical complications. This suggests that treatment recommendations may need to be sex specific.

Conclusion: Efforts should be made to address research and treatment gaps in women with stroke risk factors. This may lead to the development of sex-specific recommendations for stroke prevention and treatment.

Keywords: Atrial fibrillation carotid stenosis Endarterectomy anticoagulants.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / therapy
  • Carotid Stenosis* / complications
  • Carotid Stenosis* / diagnostic imaging
  • Carotid Stenosis* / epidemiology
  • Female
  • Humans
  • Male
  • Risk Factors
  • Sex Factors
  • Stroke* / diagnosis
  • Stroke* / epidemiology
  • Stroke* / therapy
  • Treatment Outcome