Lower stroke, TIA risk in women vs. men, depending on age
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Women have an overall lower hazard of stroke or transient ischemic attack compared with men, according to findings published in Stroke.
However, the lower risk in women was observed only in people aged 40 to 80 years. Among those younger than 30 years, stroke/TIA risk was higher in women than men, and in people older than 80 years, there was no difference in stroke/TIA risk by sex.
“Women have a lower incidence of stroke than men (1.54 vs. 1.59, respectively, per 1,000 persons) according to the Global Burden of Disease study, but a higher lifetime risk of stroke,” Manav V. Vyas, MBBS, MSc, FRCPC, of the division of neurology and Institute of Health Policy at the University of Toronto, and colleagues wrote. “Prior research has documented sex differences in stroke incidence. However, less is known about the incidence of stroke by sex and age across adult life span.”
In a cohort study, researchers analyzed 9.2 million adults aged 18 years and older (51% women) without a prior history of stroke or TIA to evaluate the association between sex and the incidence of stroke over the adult life span.
During a median follow-up of 15 years, 280,197 adults had an incident stroke or TIA; overall hazard was lower in women vs. men across all ages (HR = 0.81; 95% CI, 0.81-0.82) with consistent findings across analysis on all stroke types except for subarachnoid hemorrhage, the risk for which was higher in women (HR = 1.29; 95% CI, 1.24-1.33).
In analyses by age, in people younger than 30 years, women had higher risk for stroke or TIA than men (HR = 1.26; 95% CI, 1.1-1.45); in those aged 40 to 80 years, women had lower risk than men (HR = 0.69; 95% CI, 0.68-0.7); and in those aged 80 years or older, women and men had similar risk (HR = 0.99; 95% CI, 0.98-1.01).
“We found that there were important variations in stroke incidence in women and men across the life span; the effect of sex on stroke incidence has a U-shaped curve over adult life span with a higher risk in young women compared to young men, a lower risk in middle-aged women compared to middle-aged men and a higher risk in older women compared to older men,” Vyas told Healio. “These findings highlight the fact that looking at overall stroke incidence in women and men can mask important differences in sex-specific stroke incidence in different age groups.”
For more information:
Manav V. Vyas, MBBS, MSc, FRCPC, can be reached at manav.vyas@mail.utoronto.ca.
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