Sex and stroke

Whether in social or academic circles, discussing the differences between men and women is a fairly easy way to generate lively conversation. In this issue, Dr. Towfighi and colleagues1 report provocative findings obtained from the National Health and Nutrition Examination Surveys (NHANES). Using results from three consecutive surveys spanning the years 1999 to 2004, the authors found that women aged 45 to 54 years were more than twice as likely to have had a stroke than men of the same age. This midlife surge in stroke prevalence was paralleled by the observation that some traditional vascular risk factors, such as blood pressure and total cholesterol, increased at a greater rate in women than in men through successive decades between 35 and 64 years. The authors propose that the observed difference in midlife stroke prevalence may, in part, be explained by inadequate stroke risk factor modification in women. Important epidemiologic findings such as these, if substantiated, have the potential to impact prevention, detection, and management of cardiovascular disease and stroke in both sexes. Sex differences have been previously recognized in stroke. Similar to women with acute coronary syndromes, there are data to suggest that women with stroke may …