Women aged 35 and below are significantly more likely to have an ischemic stroke than men of the same age, an evidence review has found.
The review of more than a dozen international studies on sex differences in stroke occurrence was published in the journal Stroke.
Stroke Editor-in-Chief Ralph L. Sacco, M.D., M.S., FAHA, said:
“In this second annual Go Red Stroke issue, we have compiled some outstanding articles to inform our readers about multiple important clinical and translational science issues addressing gaps in our knowledge of stroke among women.
“Stroke affects more women each year than men. We want all stroke professionals to know about the latest research on the recognition, prevention and treatment of strokes among women.”
The researchers looked at differences in stroke incidence between women and men aged 45 and younger.
They analysed studies on large research database PubMed published between January 2008 to July 2021.
The studies included data on all types of stroke, including ischemic strokes, haemorrhagic strokes and TIAs.
A total of 16 studies from more than half a dozen countries were identified, with a combined total of 69,793 young adults with stroke (33,775 women and 36,018 men).
The greatest difference in stroke incidence was found in ischemic strokes among those aged 35 and younger.
An estimated 44 per cent more women than men in this group had an ischemic stroke.
The sex difference narrowed among adults aged between 35 and 45.
The researchers were unable to identify the specific causes of the difference in stroke occurrence.
They concluded: “Traditional atherosclerotic risk factors are a major contributor to ischemic strokes in both young men and women and become increasingly important with age.
“However, these risk factors are less prevalent in younger women and may not account for the observed higher incidence of ischemic strokes in women younger than age 35.
“Young women who are survivors of ischemic stroke also have worse outcomes, with 2 to 3 times higher risk of poorer functional outcomes compared to their male counterparts.”
The researchers said that more work is needed to better define the sex differences in ischemic stroke in young adults.
The role of non-traditional risk factors, such as pregnancy, postpartum and hormonal contraceptives should also be considered, they added.
“Our finding suggests that strokes in young adults may be happening for different reasons than strokes in older adults,” said study co-author Sharon N. Poisson, M.D., M.A.S., an associate professor of neurology at the University of Colorado, Denver.
“This emphasizes the importance of doing more studies of stroke in younger age groups so that we can better understand what puts young women at a higher risk of stroke.
“Better understanding which young adults are at risk for stroke can help us to do a better job of preventing and treating strokes in young people.”
