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Published on February 19, 2018

Who are more apt to have a stroke, men or women?

The good news is that men are having fewer strokes. The bad news is the rates in women remain the same.

Researchers at Brown University and the Long Island Jewish Medical Center discovered these findings in a study after following 1.3 million American adults over a 17-year period. Results showed that of the people who suffered a stroke, 57 percent were women.

“It may be that stroke prevention strategies are not as effective in women compared with men,” said lead researcher Dr. Tracy Madsen, assistant professor of emergency medicine at Brown’s Warren Alpert Medical School in an article in HealthDay News.

“For example, future research should investigate the possibility that stroke risk factors like elevated blood pressure, cholesterol and diabetes are more severe or are not controlled as well in women,”

“The declining rate for men is a positive development, but this study raises more questions,” said Hyannis neurologist Sean Horrigan, DO. “Simply put, one study isn’t enough,” to determine whether this is a trend, he noted.

Statistically, men are consistently at a higher risk for stroke for most age groups below age 85, he said. After age 85 this incidence reverses, with women being more at risk.

But, while men are more likely to have a stroke, there are studies suggesting that women have worse stroke recovery than men, Dr. Horrigan said.

“Many aspects of a patient’s recovery may influence this outcome. This includes sex-specific co-morbidities, aggressiveness of rehabilitation, prevention medical therapies, support services and associated mood disorders, such as depression.”

Dr. Horrigan’s patients – most of whom have had a stroke or transient ischemic attack (TIA) – are pretty evenly split between men and women, he said.

There have been other studies over the years attempting to identify differences in stroke signs and symptoms by gender, he said. These findings show that women are more likely to present with generalized weakness, fatigue, disorientation and mental status change.

“Some patients have a more challenging time discussing their health concerns and changes in health,” he said. “But I don’t believe this is a challenge more commonly identified with women, based on my own clinical experience.”

An Ounce of Prevention

Dr. Horrigan believes doctors should treat their patients, both men and women, with careful attention to symptoms and regular communication. Stroke is an acute event: a sudden loss of vision, an inability to speak, loss of strength or sensation involving the face and body. Dr. Horrigan said it is imperative that patients experiencing any of these symptoms get to an emergency department immediately.

The American Stroke Association lists high blood pressure, diabetes, smoking, poor diet, lack of exercise, high cholesterol, and obesity as some of the common stroke risk indicators that can be controlled. By treating these risk factors and maintaining regular visits with their doctors, people can reduce their risk for stroke.

While the Brown University/Long Island Jewish Medical Center study found the disparity in stroke experience by gender, findings from another recent study found that risk factors for both men and women have increased significantly.

The study of 922,451 ischemic stroke patients was conducted over a 10-year period by doctors at the University of Miami Miller School of Medicine and Yale-Griffin Prevention Research Center in Connecticut, in conjunction with the American College of Lifestyle Medicine and Lenox Hill Hospital in New York. Researchers found that each year, those who suffer from hypertension (high blood pressure) went up by 1.4 percent, the number of people with diabetes rose by 2 percent, and those with dyslipidemia rose by 7 percent.

The research reinforced the importance of patients managing their blood pressure, blood sugar and cholesterol levels.

“If blood pressure and cholesterol are well managed, you have a much lower chance of suffering a stroke,” Dr. Horrigan said. “Individuals with diabetes have a higher risk for stoke as well as heart attack and many other health complications. Diabetics have a greater responsibility to practice routine and healthy eating and exercising habits, as well as weight monitoring.”

Many aspects of a patient’s recovery may be influenced by behavior.

“In general, I advise all my patients to try their best to take better care of their bodies and maintain regular contact with their doctors,” said Dr. Horrigan.

He stressed that care providers need to be diligent and ask the same questions of men and women.

“Patients should be vigilant about reporting any concerning symptoms or changes to their health,” he said. “It always comes down to good communication. Continue to work on building a trusting and more familiar relationship with your doctor. See him or her at least once a year. This way, whenever something does occur, you know they’re ready to help you.”

Get Help FAST

The American Stroke Association encourages people to use the acronym FAST as a way to remember symptoms that could indicate a stroke:

  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911