Gender Disparities Persist in Treatment of Stroke

Raft of studies points up many of the differences in care, incidence of brain attacks


Significant gender differences continue to persist with stroke, not only in its incidence, but also in its prevention and treatment.


Among other things, women with stroke are more likely to experience emergency room delays and less likely to be treated aggressively for risk factors beforehand, according to a raft of studies coming out in a specially themed April issue of Stroke. The findings were released this week to coincide with Go Red for Women Day.


"I find it shocking that we are constantly speaking to women about empowering themselves, and then we look at the other side, and these doctors aren't delivering the care that these women need," said Dr. Suzanne Steinbaum, director of Women & Heart Disease at Lenox Hill Hospital in New York City. "We know that women who have atrial fibrillation need to be on blood thinners. Only 64 percent of women in atrial fibrillation were on blood thinners to prevent stroke. Across the board, this is the standard of care."


"There's a treatment gap and an awareness gap," said Dr. Lori Mosca, director of preventive cardiology at New York Presbyterian Hospital in New York City. "Women are more disabled by stroke, the consequences of stroke in women are greater than they are in men. The data really parallel what we see in heart disease. Women are less likely to get treated with therapies that have been proven to really benefit them."


Stroke is the third leading killer among women. And it's expected that the incidence and hence, the burden, of stroke among women will only increase with time and the aging of the population.


By 2050, according to projections, death from stroke among women will exceed that in men by 30 percent.


One group of researchers reporting in this issue of the journal found that women with ischemic stroke (when an artery to the brain is clogged) were 14 percent less likely to receive what the authors called "perfect" or "defect-free" care.


Overall, the absolute differences between genders were small, but more troubling and clinically relevant gaps existed in how many women were treated with tPA (clot-busting drug) and in how well they were treated for high cholesterol.


Women were also 16 percent less likely to be sent home after a stroke, meaning they were more likely to be institutionalized, than men.


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.