Sex differences in stroke: Challenges and opportunities

Author:

Bushnell Cheryl D1,Chaturvedi Seemant2,Gage Kathy R3,Herson Paco S4,Hurn Patricia D5,Jiménez Monik C6,Kittner Steven J7,Madsen Tracy E8,McCullough Louise D9,McDermott Mollie10,Reeves Mathew J11,Rundek Tatjana2

Affiliation:

1. Wake Forest School of Medicine, Winston Salem, NC, USA

2. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA

3. Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA

4. Department of Anesthesiology, University of Colorado, Denver, CO, USA

5. School of Nursing, University of Michigan, Ann Arbor, MI, USA

6. Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA, USA

7. Baltimore Veterans Administration Medical Center and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA

8. Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA

9. Department of Neurology, University of Texas at Houston, Houston, TX, USA

10. Stroke Program, University of Michigan, Ann Arbor, MI, USA

11. Department of Epidemiology and Biostatistics, Michigan State University, Lansing, MI, USA

Abstract

Biologic sex influences many variables that are important to brain health in general, and to stroke or cerebral ischemia in particular, such as general health status, cerebrovascular anatomy and function, unique risk factors such as pregnancy and preeclampsia, symptomatology, and therapeutic response. A more complete understanding of the scale and depth of sexual dimorphism in the brain and the role of more general sex-based factors is crucial to reducing the burden of stroke in women and men. This focused review highlights recent findings in stroke, including sex differences in epidemiology, risk factor reduction, comparative use of stroke therapeutics in both sexes, the importance of frailty in women, and the biologic basis for sex differences in stroke. Such findings show tremendous promise for the future of personalized medicine in stroke prevention and treatment.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Clinical Neurology,Neurology

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