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Nat Rev Neurol. 2017 Sep;13(9):521-532. doi: 10.1038/nrneurol.2017.95. Epub 2017 Jul 21.

Stroke in women - from evidence to inequalities.

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University of Lille, INSERM U1171, Degenerative &vascular cognitive disorders, Centre Hospitalier Universitaire, Department of Neurology, F-59000 Lille, France.
Division of Clinical Neurosciences, University of Nottingham, Hucknall Road, NG5 1PB, UK.
Department of Neurology, Oslo University Hospital, Oslo, Norway and the George Institute of Public Health, Sydney, Australia.
Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade 11000, Serbia.
Rehabilitation Medicine, Sect for Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Blå Stråket 7, University of Gothenburg, Gothenburg, 41345, Sweden.
Stroke Unit, Santa Maria della Misericordia Hospital, University of Perugia, Via E. Dottori, 06156 Perugia, Italy.
Department of Neurology, Bispebjerg og Frederiksberg Hospital, Bispebjerg Bakke 23, University of Copenhagen, 2400 NV, Denmark.


Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke - including diabetes mellitus and atrial fibrillation - are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy. However, in an era of evidence-based medicine, women are notably under-represented in clinical trials - despite governmental actions highlighting the need to include both men and women in clinical trials - resulting in a reduced generalizability of study results to women. The aim of this Review is to highlight new insights into specificities of stroke in women, to plan future research priorities, and to influence public health policies to decrease the worldwide burden of stroke in women.


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