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

• Published in: Frontiers in neuroendocrinology 2020-10, Vol.59, p.100870-100870, Article 100870
• Main Authors: Carcel, Cheryl, Woodward, Mark, Wang, Xia, Bushnell, Cheryl, Sandset, Else Charlotte
• Format: Article
• Language: English
• Subjects: Gender; Intracerebral hemorrhage; Ischemic stroke; Sex; Sex differences; Stroke
• ISSN: 0091-3022; 1095-6808
• DOI: 10.1016/j.yfrne.2020.100870

•There is clinical and public health significance in analyzing stroke results by sex.•Stroke incidence is higher in men but affect more women because of their longevity.•Worse outcomes in women may be explained by age and other comorbidities.•The interaction with the stroke healthcare system by sex are not well understood.•Further sex differences research is needed in many areas of stroke. 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.