Women more likely to die within a year of experiencing their first stroke compared to men, finds study

Strokes and heart attacks are leading causes of death worldwide but their symptoms and risk factors often differ widely among men and women. The American Heart Association says that while both men and women experience some of the same stroke symptoms, others like fainting, agitation, nausea, vomiting, confusion, general weakness and seizures are unique to women. Given these differences, people often fail to recognise strokes in women on time and this leads to worse outcomes for them. Different strokes for men and women A study published in the journal Neuroepidemiology in 2015 suggests that women tend to survive longer than men and therefore experience strokes at an older age when more underlying diseases are likely to ail them too. Women, this study says, tend to have strokes associated with a higher prevalence of hypertension, atrial fibrillation and pre-stroke disability while men have a greater association with heart disease, peripheral vascular disease, smoking and alcohol use. However, these basic sex differences are not often taken into account while treating strokes in women, which is why their risk of mortality may be higher. Another study published in Circulation in 2017 explains that greater age at the time of the first stroke, pre-stroke limitations and disabilities, greater stroke severity and atrial fibrillation majorly affect the survival rates of women. While lower survival rates for stroke among the elderly are understandable, in the case of women, more in-depth studies can provide better avenues for gender-based interventions and therapy. Greater mortality among women  A new study published in the Journal of Women’s Health explains that this risk of mortality associated with women suffering from strokes may be much higher than previously estimated. The Australian study aimed to understand if mortality up to a year after stroke varies by sex and, if it does, which evidence-based care factors contribute to an increase in mortality. To do this, the researchers behind this study collected all relevant data of first-ever strokes from the Australian Stroke Clinical Registry of 35 hospitals between 2010 and 2013. The researchers selected 9,441 cases, 46 percent of whom were women. During the one-year follow up for all patients, cause-specific mortality was categorized by primary, secondary and recurrent stroke, ischemic heart disease, cardiovascular disease and cancer. Hazard ratios (HR) and mortality ratios (MR) were calculated accordingly by the researchers. The researchers found that the women suffering from stroke were seven years older than the men on average. These women also had more severe strokes based on the fact that 9.3 percent fewer of them could walk independently at the time of hospital admission. Evidence-based treatment of women is lacking The researchers noted that the women had comorbidities like dementia, hypertension, atrial fibrillation and heart failure, while the men were more often smokers, had high cholesterol and diabetes. They also found that women received suboptimal care and recommendations for medications that can prevent a secondary stroke. In the following one-year period after discharge, women had greater all-cause MR at 25.4 percent while it was 19.1 percent for men. Secondary strokes and cardiovascular events accounted for over half of all deaths within one year of the first stroke irrespective of sex differences. However, some sex-difference patterns were observed. Around 50 percent of the women died due to secondary strokes while only 41 percent of men died of the same cause. Women also experienced more cardiovascular deaths at 16 percent rather than men (13 percent). More men died due to cancer (12 percent compared to six percent of women) and ischemic heart disease (eight percent compared to six percent of women). This data analysis points out that cause-specific mortality rates after the first-ever stroke differs by sex as more women die due to secondary strokes and cardiovascular complications than men. The researchers concluded that women had a 65 percent greater risk of stroke-associated death. The severity of the first stroke was much worse in women, which is explained by their age progression compared to men. Proper risk factor and comorbidity diagnosis are needed to treat women. Their therapy and medications on discharge should be based on case-specific evidence rather than generalised, fit-for-all methods. The researchers also recommend that the prevention of secondary strokes should be the key area of focus for all healthcare professionals. For more information, read our article on Stroke. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.