Strokes and heart attacks are the leading causes of death in the world, but their symptoms and risk factors often differ greatly between men and women.
The American Heart Association says that while both men and women have some of the same stroke symptoms, others like fainting, anxiety, nausea, vomiting, confusion, general weakness, and seizures are unique to women.
Given these differences, men often do not recognize strokes in women in time and this leads to worse outcomes for them.
Different moves for men and women
Study published in the journal Neuroepidemiology in 2015 suggests that women tend to survive longer than men and therefore experience strokes in old age when they are likely to suffer from some underlying diseases as well.
This study says that women have strokes associated with a higher prevalence of hypertension, atrial fibrillation and disability before stroke, while men have a greater association with heart disease, peripheral vascular disease, smoking and alcohol use.
However, these basic gender differences are not often taken into account when treating stroke in women, making the risk of mortality higher.
Another study published in Circulation in 2017 explains that higher age at the time of first stroke, pre-stroke limitations and deficiencies, higher stroke severity, and atrial fibrillation mainly affect women’s survival rates.
Although lower survival rates from stroke in the elderly are understandable, in the case of women, more detailed research may provide a better pathway for gender-based interventions and therapy.
Higher mortality among women
A new study published in Journal of Women’s Health explains that this risk of mortality associated with women suffering from stroke may be much higher than previously estimated.
An Australian study aimed to find out whether mortality up to a year after a stroke varies by gender and, if different, which evidence-based care factors contribute to increased mortality.
To do so, the researchers behind this study collected all relevant data on the first stroke from the Australian Clinical Stroke Registry in 35 hospitals between 2010 and 2013. The researchers selected 9,441 cases, of which 46 percent were women.
During the one-year follow-up for all patients, cause-specific mortality was categorized according to primary, secondary, and recurrent stroke, ischemic heart disease, cardiovascular disease, and cancer. The researchers calculated risk (HR) and mortality (MR) ratios accordingly.
The researchers found that women who suffer a stroke are seven years older than men on average. These women also had more severe strokes based on the fact that 9.3 percent fewer of them were able to walk independently at the time of admission to the hospital.
Evidence-based treatment is lacking
The researchers noted that women had comorbidities such as dementia, hypertension, atrial fibrillation and heart failure, while men smoked more often, had elevated cholesterol and diabetes. They also found that women were given suboptimal care and recommendations for medications that could prevent secondary stroke.
In the year following discharge, women had a higher MRI for all causes of 25.4 percent, while for men it was 19.1 percent. Secondary stroke and cardiovascular events accounted for more than half of all deaths within one year of the first stroke, regardless of gender differences. However, some patterns of gender differences have been observed. About 50 percent of women died from secondary strokes, while only 41 percent of men died from the same cause. Women also experienced more cardiovascular deaths with 16 percent than men (13 percent). More men died of cancer (12 percent compared to six percent of women) and ischemic heart disease (eight percent compared to six percent of women).
This data analysis suggests that cause-specific mortality rates after the first stroke vary by gender as more women die from secondary strokes and cardiovascular complications than men.
The researchers concluded that women have a 65 percent higher risk of death associated with stroke. The severity of the first stroke was much worse in women, which is explained by their age progression compared to men. Appropriate risk factor and diagnosis of comorbidity are required for the treatment of women.
Their therapy and medications on discharge should be based on case-by-case evidence rather than general, appropriate for all methods. Researchers also recommend that the prevention of secondary strokes be a key area of focus for all health professionals.
For more information, read our article on stroke.
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