Sex differences and stroke prevention

International Women’s Day was fast approaching as this issue of The Lancet Neurology went to press, so it seemed appropriate to celebrate the publication of the first set of guidelines to focus exclusively on the prevention of stroke in women. The guidelines from the American Heart Association (AHA) and the American Stroke Association identify stroke risk factors that are unique to or more common in women, or that preferentially increase risk in women compared with men, and provide evidence-based recommendations for stroke prevention across the lifespan.

Women have a higher lifetime risk of stroke than men and stroke mortality is higher in women than in men in high-income countries. In the USA, 76 769 (60%) of the 128 842 deaths related to stroke in 2009 occurred in women. These facts are often attributed to the longer life expectancy of women. As the population ages, the prevalence of stroke survivors is expected to increase, especially among older women. Poorer outcomes in women have been reported and could add to the anticipated increase in the burden of stroke. There is a pressing need for earlier identification of women at risk of stroke so that effective prevention strategies can be initiated. Education of younger women about stroke risk and prevention at different life stages will be key to this goal, and the new guidelines are an important step in the right direction. Read More