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Cited by 86Acute Ischemic Stroke ManagementSex and Gender in HealthcareCerebrovascular and Carotid Artery Diseases

Gender differences in presenting and prodromal stroke symptoms

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Stuart-Shor, Eileen M., Wellenius, Gregory A., DelloIacono, Donna M., Mittleman, Murray A.·2009·Stroke
DOI 10.1161/strokeaha.108.543371PMC PMC2753397
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Abstract

BACKGROUND AND PURPOSE: Prompt recognition of stroke symptoms is critical to timely treatment and women have increased delay to treatment. Women may be more likely to present with atypical symptoms, but this hypothesis has not been extensively evaluated. METHODS: We examined gender differences in the prevalence of presenting and prodromal stroke symptoms among 1107 consecutive patients hospitalized with neurologist-confirmed acute ischemic stroke. Patient demographics, clinical variables, and stroke symptoms were abstracted from medical records by trained abstractors using standardized forms. Estimates were age-standardized to the age distribution of men and women combined. Presenting symptoms occurred within 24 hours of incident stroke admission; prodromal symptoms occurred >or=24 hours of admission. RESULTS: Women were significantly older (P<0.001), more likely to have cardioembolic stroke (P<0.01), and less likely to receive aspirin (P=0.014) or statins (P<0.001). Thirty-five percent of the sample (n=389) reported prodromal symptoms. Women were more likely to have >or=1 somatic prodromal and presenting symptoms (P=0.03; P=0.008), but did not differ from men on specific somatic symptoms. Women did not differ from men in classic presenting stroke symptoms (P=0.89). CONCLUSIONS: Women did not differ significantly in the prevalence of traditional stroke symptoms but were more likely to have somatic presenting and prodromal symptoms. We found no differences in specific prodromal symptoms, making it difficult to craft a public health message about gender differences in early warning signs of stroke. These results suggest that the focus of stroke prevention education for women should continue to emphasize traditional stroke risk factors.

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  • In a 2009 study of 1107 inpatients with neuro-ischemic stroke, there was no difference in prevalence of stroke between men and women, but women were older and more likely to have heart embolism.

    “In 2009, a study conducted by the Beth Israel Deaconess Medical Center in the USA analyzed 1107 inpatients aged 21 and older who were diagnosed with neuro-ischemic stroke [28]. This study revealed no difference in the prevalence of stroke between men and women, but when comparing the age of patients, women were older than men and were more likely to have heart embolism [28].”

    From Effect of Caffeine Consumption on the Risk for Neurological and Psychiatric Disorders: Sex Differences in Human (2020) · cites this paper as [28]

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Authors
Stuart-Shor, E. M., Wellenius, G. A., DelloIacono, D. M., & Mittleman, M. A.
Affiliations
  • From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School (E.M.S., G.A.W., M.A.M.), Boston, Mass; the College of Nursing and Health Sciences, University of Massachusetts Boston (E.M.S., D.M.D.); and the Department of Neurosurgery, Brigham and Women’s Hospital (D.M.D.), Boston, Mass.
  • Brigham and Women's Hospital (US)
ORCID
Venue
Stroke
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2009-04
Volume
40
Issue
4
Pages
1121-1126
ISSN
  • 0039-2499 (ISSN-L)
  • 1524-4628
DOI
10.1161/strokeaha.108.543371
PMC
PMC2753397
OpenAlex
W2136109897
Cited by
86
References
34
Citations by year
2025: 3 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 5 · 2020: 8 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 6 · 2015: 5 · 2014: 6 · 2013: 7 · 2012: 3
FWCI
2.92
Type
journal article
Language
en
Open access
Locations
  • Stroke (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Massachusetts Boston
  • National Institutes of Health (NIH T32, NIH K99)
  • U.S. Public Health Service (T32 HLO7374-23)
  • National Heart, Lung, and Blood Institute
  • National Institute of Environmental Health Sciences (P01ES009825, ES015774, ES009825, R00ES015774, K99ES015774)
Topics
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
Keywords
gender differences, acute ischemic stroke, stroke symptoms, prodromal symptoms, somatic symptoms, atypical stroke presentation, stroke prevention education, cardioembolic stroke, aspirin use, statin use, women
MeSH terms
Acute Disease, Aged, Aged, 80 and over, Brain Ischemia, Female, Hospitalization, Humans, Male, Middle Aged, Risk Factors, Sex Characteristics, Incidence, Prevalence, Stroke

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