Stroke in WomenERRATUM

Hanne Christensen, MD, PhD, DMSci; Cheryl Bushnell, MD, MHS Cerebrovascular Disease p. 363-385 April 2020, Vol.26, No.2 doi: 10.1212/CON.0000000000000836
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PURPOSE OF REVIEW This article reviews sex differences in stroke risk and presentation, with a particular emphasis on the unique risk factors women experience throughout the lifespan.

RECENT FINDINGS Although prior studies suggested women have worse outcomes after stroke, it is now clear that age, prestroke functional status, and comorbidities explain many of the differences between men and women in stroke severity, functional outcomes, and mortality. Several meta-analyses and large cohort studies have evaluated the risk factors for women related to reproductive factors and found that fewer years between menarche and menopause, pregnancy complications (preeclampsia/eclampsia, preterm delivery, and stillbirth), oophorectomy, hormone replacement therapy use, and younger age at menopause all increase the risk of stroke. Although the nonreproductive risks of stroke overlap between men and women, those with greater impact on women include age, hypertension, atrial fibrillation, socioeconomic status, and depression.

SUMMARY Significant sex differences are observed in risk factors of stroke and stroke outcome. Including this information in the clinical assessment of the individual patient may support development of more effective prevention plans.

Address correspondence to Dr Cheryl Bushnell, Department of Neurology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, cbushnel@wakehealth.edu.

RELATIONSHIP DISCLOSURE: Dr Christensen has served on the advisory board of Boehringer Ingelheim International GmbH and has received personal compensation for speaking engagements from Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, and Daiichi-Sankyo. Dr Christensen has received research/grant support from the Lundbeck Foundation, Toyota Fonden Denmark, the TrygFonden, and the Velux Foundations and publishing royalties from Gyldendal Forlag. Dr Bushnell has received research/grant support from the Agency for Healthcare Research and Quality (1R01HS025723-01), the National Institutes of Health/National Institute of Neurological Diseases and Stroke (1U24NS107235-01), and the Patient-Centered Outcomes Research Institute (PCS-11403-14531) and publishing royalties from Henry Stewart Talks Ltd and Oxford University Press.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Drs Christensen and Bushnell report no disclosures.

© 2020 American Academy of Neurology.