Gender gap in cerebrovascular accidents: comparison of the extent, severity, and risk factors in men and women aged 45-65.

Background and objective: Few data are available on sex differences among relatively young adult stroke patients. The aim of the present study is to analyze such differences in mortality, principal risk factors, and outcome measures among patients aged 45-65 with acute stroke. The identification of these differences is indispensable for developing optimal strategies for the prevention and care of this disease.

Methods and results: Retrospective study of 114 women and 190 men, aged 45-65 years, hospitalized from 1990 to 1998 in the Hadassah Medical Centers with confirmed CVA. Medical background, clinical presentation, imaging results, risk factors, lifestyle information, and rehabilitative status data were retrieved from medical records. No gender differences were observed in clinical presentation or imaging studies. In-hospital mortality rate among women was higher than men, 13.2% vs. 5.8%. A significant gender gap in comorbidity with diabetes, hypertension, and hypercholesterolemia was found: 29.1% of women vs. 14.3% of men. Men more than women had a history of ischemic heart disease (35.8% vs. 21.9%) and smoking and alcohol consumption (43.9% vs. 16.4%; 6.9% vs. 0.9%). Use of rehabilitative services was similar between the sexes.

Conclusions: This study shows marked gender differences among younger adult stroke patients. The concomitance of multiple risk factors in the women may have contributed to the observed higher mortality rate. Characterization of risk factors for CVA in both sexes may aid in developing prevention strategies to reduce stroke incidence in this age group.