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Women may be experiencing strokes more often than men

The overall incidence of stroke decreased among men, but remained the same among women, between 1993 and 2010, according to research recently published in Neurology.

Across both sexes, strokes are responsible for 130,000 deaths — or one of every 20 deaths — in the U.S. annually, according to CDC.

“Overall stroke incidence has been decreasing over time, but whether there are sex differences in temporal trends of stroke incidence is less clear,” Tracy E. Madsen, MD, ScM, of the department of emergency medicine at The Alpert Medical School of Brown University and colleagues wrote.

To gather more information, researchers studied data from 1.3 million residents of northern Kentucky and southwest Ohio from July 1993 to June 1994, and all of 1999, 2005 and 2010. A sampling scheme determined out-of-hospital cases. Sex-specific incidence rates per 100,000 among black and white participants, age- and race-adjusted, were formalized to the 2000 Census. Researchers also analyzed trends over time by a resident’s sex, and used a Bonferroni correction for multiple comparisons.

Madsen and colleagues found that were 7,710 incident strokes during the period studied, and 57.2% occurred in women. In addition, researchers also stated that the decrease in occurrence of all strokes over time was significant only in men. There was a decrease in occurrence between 1993/1994 and 2010 for men (263 per 100,000 in 1993/1994 to 192 per 100,000 in 2010, P < .001). There was no increase for women (217 per 100,000 in 1993/1994 to 198 per 100,000 in 2010, P = .15). Similar differences were observed for ischemic stroke with men (238 per 100,000 to 165 per 100,000; P = .01) and women (193 per 100,000 to 173 per 100,000; P = .09). Researchers also noted that occurrence of subarachnoid and intracerebral hemorrhages were stable over time in men and women, and occurrence of all strokes and of ischemic strokes was similar among both sexes in 2010.

“The overall decrease in stroke was driven by men having fewer ischemic strokes,” Madsen said in a press release. “What is not clear is why stroke rates for women remained stable while the rates for men decreased.”

Researchers wrote that possible explanations include fluctuations in the study population, fewer women than men able to live independently during the period examined, and that stroke risk factors are not as well managed in women.

“Our current findings, in combination with our group’s past work showing that stroke incidence is not decreasing to the same extent in black compared with white participants, demonstrate that targeted stroke prevention efforts may be needed to effectively decrease stroke incidence, and thus mortality from stroke, across all demographic groups,” Madsen and colleagues wrote. – by Janel Miller

Reference:

CDC’s Webpage on Strokes. https://www.cdc.gov/stroke/facts.htm. Accessed August 7, 2017.

Disclosure: Madsen reports no relevant financial disclosures. Please see the study for a full list of the other authors relevant financial disclosures.