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Stroke and Cognitive Disorder in Women

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Manual of Gynecardiology

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Abstract

Women have a higher prevalence of stroke at an older age compared to men. Atrial fibrillation (AF) and diabetes have a higher mortality and stroke risk in women than in men. Migraine with aura is twice to four times as common in women than in men and doubles the risk of stroke. A previous history of preeclampsia is an independent female-specific risk factor for stroke. The use of hormonal therapy (HT) in menopause also increases stroke risk. Women may have more speech difficulties at onset of stroke, which may delay hospital referral. This chapter updates our knowledge on sex- and gender differences in stroke.

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References

  1. Arnao V, Acciarresi M, Cittadini E, Caso V. Stroke incidence, prevalence and mortality in women worldwide. Int J Stroke. 2016;11:287–301.

    Article  PubMed  Google Scholar 

  2. Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Au R, Kannel WB, Wolf PA. The lifetime risk of stroke: estimates from the Framingham study. Stroke. 2006;37:345–50.

    Article  PubMed  Google Scholar 

  3. Kolominsky-Rabas PL, Wiedmann S, Weingärtner M, Liman TG, Endres M, Schwab S, Buchfelder M, Heuschmann PU. Time trends in incidence of pathological and etiological stroke subtypes during 16 years: the Erlangen Stroke Project. Neuroepidemiology. 2015;44(1):24–9.

    Article  PubMed  Google Scholar 

  4. Carandang R, Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Kannel WB, Wolf PA. Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years. JAMA. 2006;296:2939–46.

    Article  CAS  PubMed  Google Scholar 

  5. Heuschmann PU, Grieve AP, Toschke AM, Rudd AG, Wolfe CD. Ethnic group disparities in 10-year trends in stroke incidence and vascular risk factors: the South London Stroke Register (SLSR). Stroke. 2008;39:2204–10.

    Article  PubMed  Google Scholar 

  6. Wieberdink RG, Ikram MA, Hofman A, Koudstaal PJ, Breteler MM. Trends in stroke incidence rates and stroke risk factors in Rotterdam, the Netherlands from 1990 to 2008. Eur J Epidemiol. 2012;27:287–95.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rosengren A, Giang KW, Lappas G, Jern C, Torén K, Björck L. Twenty-four-year trends in the incidence of ischemic stroke in Sweden from 1987 to 2010. Stroke. 2013;44:2388–93.

    Article  PubMed  Google Scholar 

  8. World Health Organisation. Cerebrovascular disorders (offset publications). Geneva: World Health Organization; 1978. isbn:978-92-4-170043-2.

    Google Scholar 

  9. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, Hatsukami TS, Higashida RT, Johnston SC, Kidwell CS, Lutsep HL, Miller E, Sacco RL, American Heart Association, American Stroke Association Stroke Council, Council on Cardiovascular Surgery and Anesthesia, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Nursing, Interdisciplinary Council on Peripheral Vascular Disease. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009;40:2276–93.

    Article  PubMed  Google Scholar 

  10. Petrea RE, Beiser AS, Seshadri S, Kelly-Hayes M, Kase CS, Wolf PA. Gender differences in stroke incidence and poststroke disability in the Framingham heart study. Stroke. 2009;40:1032–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Rothwell PM, Coull AJ, Silver LE, Fairhead JF, Giles MF, Lovelock CE, Redgrave JN, Bull LM, Welch SJ, Cuthbertson FC, Binney LE, Gutnikov SA, Anslow P, Banning AP, Mant D, Mehta Z. Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). Lancet. 2005;366:1773–83.

    Article  CAS  PubMed  Google Scholar 

  12. Haberman S, Capildeo R, Rose FC. Sex differences in the incidence of cerebrovascular disease. J Epidemiol Community Health. 1981;35:45–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Nilsson OG, Lindgren A, Ståhl N, Brandt L, Säveland H. Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden. J Neurol Neurosurg Psychiatry. 2000;69:601–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Jacobs BS, Boden-Albala B, Lin IF, Sacco RL. Stroke in the young in the Northern Manhattan Stroke Study. Stroke. 2002;33:2789–93.

    Article  PubMed  Google Scholar 

  15. Appelros P, Jonsson F, Asplund K, Eriksson M, Glader EL, Asberg KH, Norrving B, Stegmayr B, Terént A, Riks-Stroke Collaboration. Trends in baseline patient characteristics during the years 1995–2008: observations from risk-stroke, the Swedish Stroke Register. Cerebrovasc Dis. 2010;30:114–9.

    Article  PubMed  Google Scholar 

  16. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation. 2013;127:e6–e245.

    Article  PubMed  Google Scholar 

  17. Mendis S. Prevention and care of stroke in low- and middle-income countries; the need for a public health perspective. Int J Stroke. 2010;5:86–91.

    Article  CAS  PubMed  Google Scholar 

  18. de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007;78:1365–72.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kleindorfer D, Broderick J, Khoury J, Flaherty M, Woo D, Alwell K, Moomaw CJ, Schneider A, Miller R, Shukla R, Kissela B. The unchanging incidence and case-fatality of stroke in the 1990s: a population-based study. Stroke. 2006;37:2473–8.

    Article  PubMed  Google Scholar 

  20. Wardlaw JM, White PM. The detection and management of unruptured intracranial aneurysms. Brain. 2000;123:205–21.

    Article  PubMed  Google Scholar 

  21. Algra AM, Klijn CJ, Helmerhorst FM, Algra A, Rinkel GJ. Female risk factors for subarachnoid hemorrhage: a systematic review. Neurology. 2012;79:1230–6.

    Article  PubMed  Google Scholar 

  22. Levine DA, Galecki AT, Langa KM, Unverzagt FW, Kabeto MU, Giordani B, Wadley VG. Trajectory of cognitive decline after incident stroke. JAMA. 2015;314:41–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Liebetrau M, Steen B, Skoog I. Stroke in 85-year-olds: prevalence, incidence, risk factors, and relation to mortality and dementia. Stroke. 2003;34:2617–22.

    Article  PubMed  Google Scholar 

  24. Zhu L, Fratiglioni L, Guo Z, Winblad B, Viitanen M. Incidence of stroke in relation to cognitive function and dementia in the Kungsholmen project. Neurology. 2000;54:2103–7.

    Article  CAS  PubMed  Google Scholar 

  25. Feigin VL, Krishnamurthi RV, Parmar P, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990–2013: the GBD 2013 study. Neuroepidemiology. 2015;45:161–76.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Wu YT, Fratiglioni L, Matthews FE, et al. Dementia in Western Europe: epidemiological evidence and implications for policy making. Lancet Neurol. 2016;15:116–24.

    Article  PubMed  Google Scholar 

  27. Satizabal CL, Beiser AS, Chouraki V, Chene G, Dufouil C, Seshadri S. Incidence of dementia over three decades in the Framingham Heart Study. N Engl J Med. 2016;374:523–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesbery WR. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA. 1997;277:813–7.

    Article  CAS  PubMed  Google Scholar 

  29. Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA. 2014;312:2551–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Cooper LL, Woodard T, Sigurdsson S, van Buchem MA, Torjesen AA, Inker LA, Aspelund T, Eiriksdottir G, Harris TB, Gudnason V, Launer LJ, Mitchell GF. Cerebrovascular damage mediates relations between aortic stiffness and memory. Hypertension. 2016;67:176–82.

    Article  CAS  PubMed  Google Scholar 

  31. Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, Howard VJ, Lichtman JH, Lisabeth LD, Piña IL, Reeves MJ, Rexrode KM, Saposnik G, Singh V, Towfighi A, Vaccarino V, Walters MR, American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council for High Blood Pressure Research. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:1545–88.

    Article  PubMed  Google Scholar 

  32. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, Rangarajan S, Islam S, Pais P, McQueen MJ, Mondo C, Damasceno A, Lopez-Jaramillo P, Hankey GJ, Dans AL, Yusoff K, Truelsen T, Diener HC, Sacco RL, Ryglewicz D, Czlonkowska A, Weimar C, Wang X, Yusuf S, INTERSTROKE Investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376:112–23.

    Article  PubMed  Google Scholar 

  33. Peters SA, Huxley RR, Woodward M. Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3,980,359 individuals and 42,401 strokes. Stroke. 2013;44:2821–8.

    Article  PubMed  Google Scholar 

  34. Turnbull F, Woodward M, Neal B, Barzi F, Ninomiya T, Chalmers J, Perkovic V, Li N, MacMahon S, Blood Pressure Lowering Treatment Trialists’ Collaboration. Do men and women respond differently to blood pressure-lowering treatment? Results of prospectively designed overviews of randomized trials. Eur Heart J. 2008;29(21):2669–80.

    Article  PubMed  Google Scholar 

  35. Neovius M, Janson A, Rössner S. Prevalence of obesity in Sweden. Obes Rev. 2006;7:1–3.

    Article  CAS  PubMed  Google Scholar 

  36. Giampaoli S, Palmieri L, Donfrancesco C, Lo Noce C, Pilotto L, Vanuzzo D, Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey Research Group. Cardiovascular health in Italy. Ten-year surveillance of cardiovascular diseases and risk factors: Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 1998-2012. Eur J Prev Cardiol. 2015;22:9–37.

    Article  PubMed  Google Scholar 

  37. Friberg L, Bergfeldt L. Atrial fibrillation prevalence revisited. J Intern Med. 2013;274(5):461–8.

    Article  CAS  PubMed  Google Scholar 

  38. Go AS, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) study. JAMA. 2001;285:2370–5.

    Article  CAS  PubMed  Google Scholar 

  39. Heeringa J, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27(8):949–53.

    Article  PubMed  Google Scholar 

  40. Michelena HI, Powell BD, Brady PA, Friedman PA, Ezekowitz MD. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110:1042–6.

    Article  Google Scholar 

  41. Emdin CA, Wong CX, Hsiao AJ, Altman DG, Peters SA, Woodward M, Odutayo AA. Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies. BMJ. 2016;53:h7013.

    Article  Google Scholar 

  42. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P, Agewall S, Camm J, Baron Esquivias G, Budts W, Carerj S, Casselman F, Coca A, De Caterina R, Deftereos S, Dobrev D, Ferro JM, Filippatos G, Fitzsimons D, Gorenek B, Guenoun M, Hohnloser SH, Kolh P, Lip GY, Manolis A, McMurray J, Ponikowski P, Rosenhek R, Ruschitzka F, Savelieva I, Sharma S, Suwalski P, Tamargo JL, Taylor CJ, Van Gelder IC, Voors AA, Windecker S, Zamorano JL, Zeppenfeld K. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–962.

    Google Scholar 

  43. Conolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.

    Article  Google Scholar 

  44. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91.

    Article  CAS  PubMed  Google Scholar 

  45. Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.

    Article  CAS  PubMed  Google Scholar 

  46. Hendriks SH, van Hateren KJ, Groenier KH, Houweling ST, Maas AH, Kleefstra N, Bilo HJ. Sex differences in the quality of diabetes care in the Netherlands (ZODIAC-45). PLoS One. 2015;10:e0145907.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Kurth T, Winter AC, Eliassen AH, Dushkes R, Mukamal KJ, Rimm EB, Willett WC, Manson JE, Rexrode KM. Migraine and risk of cardiovascular disease in women: prospective cohort study. BMJ. 2016;353:i2610.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Tepper NK, Whiteman MK, Zapata LB, Marchbanks PA, Curtis KM. Safety of hormonal contraceptives among women with migraine: a systematic review. Contraception. 2016;94(6):630–40.

    Article  CAS  PubMed  Google Scholar 

  49. MacClellan LR, Giles W, Cole J, Wozniak M, Stern B, Mitchell BD, Kittner SJ. Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke. 2007;38:2438–45.

    Article  PubMed  Google Scholar 

  50. Brayfield A. Martindale the complete drug reference. 38th ed. New York: Pharmaceutical Press; 2014. isbn:978-0-85711-139-5.

    Google Scholar 

  51. Boardman HM, Hartley L, Eisinga A, Main C, Roqué i Figuls M, Bonfill Cosp X, Gabriel Sanchez R, Knight B. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev. 2015;3:CD002229.

    Google Scholar 

  52. Nelson HD, Walker M, Zakher B, Mitchell J. Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the U.S. Preventive Services Task Force recommendations. Ann Intern Med. 2012;157:104–13.

    Article  PubMed  Google Scholar 

  53. Grodstein F, Manson JE, Stampfer MJ, Rexrode K. Postmenopausal hormone therapy and stroke: role of time since menopause and age at initiation of hormone therapy. Arch Intern Med. 2008;168:861–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Chan W-S, Ray J, Wai EK, Ginsburg S, Hannah ME, Corey PN, Ginsberg JS. Risk of stroke in women exposed to low-dose oral contraceptives: a critical evaluation of the evidence. Arch Intern Med. 2004;164:741–7.

    Article  PubMed  Google Scholar 

  55. Baillargeon JP, McClish DK, Essah PA, Nestler JE. Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab. 2005;90:3863–70.

    Article  CAS  PubMed  Google Scholar 

  56. Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012;366(24):2257–66.

    Article  CAS  PubMed  Google Scholar 

  57. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Ischaemic stroke and combined oral contraceptives: results of an international, multicenter, case-control study. Lancet. 1996;348:498–505.

    Article  Google Scholar 

  58. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicenter, case-control study. Lancet. 1996;348:505–10.

    Article  Google Scholar 

  59. Kemmeren JM, Tanis BC, van den Bosch MA, Bollen EL, Helmerhorst FM, van der Graaf Y, Rosendaal FR, Algra A. Risk of arterial thrombosis in relation to oral contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke. Stroke. 2002;33:1202–8.

    Article  PubMed  Google Scholar 

  60. Slooter AJ, Rosendaal FR, Tanis BC, Kemmeren JM, van der Graaf Y, Algra A. Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke. J Thromb Haemost. 2005;3:1213–7.

    Article  CAS  PubMed  Google Scholar 

  61. Urbanus RT, Siegerink B, Roest M, Rosendaal FR, de Groot PG, Algra A. Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study. Lancet Neurol. 2009;8:998–1005.

    Article  CAS  PubMed  Google Scholar 

  62. Duley L, Meher S, Jones L. Drugs for treatment of very high blood pressure during pregnancy. Cochrane Database Syst Rev. 2013;7:CD001449.

    Google Scholar 

  63. Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2014;2:CD002252.

    Google Scholar 

  64. European Society of Gynecology (ESG), Association for European Paediatric Cardiology (AEPC), German Society for Gender Medicine (DGesGM), Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, Cifkova R, Ferreira R, Foidart JM, Gibbs JS, Gohlke-Baerwolf C, Gorenek B, Iung B, Kirby M, Maas AH, Morais J, Nihoyannopoulos P, Pieper PG, Presbitero P, Roos-Hesselink JW, Schaufelberger M, Seeland U, Torracca L, ESC Committee for Practice Guidelines. ESC guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:3147–97.

    Article  Google Scholar 

  65. McDonald SD, Malinowski A, Zhou Q, Yusuf S, Devereaux PJ. Cardiovascular sequelae of preeclampsia/eclampsia: a systematic review and meta-analyses. Am Heart J. 2008;156:918–30.

    Article  PubMed  Google Scholar 

  66. Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014;6:CD001059.

    Google Scholar 

  67. WHO Recommendations. http://www.who.int/elena/titles/calcium_pregnancy/en/. Accessed 31 Jul 2016.

  68. Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007;2:CD004659.

    Google Scholar 

  69. Leffert LR, Clancy CR, Bateman BT, Cox M, Schulte PJ, Smith EE, Fonarow GC, Kuklina EV, George MG, Schwamm LH. Treatment patterns and short-term outcomes in ischemic stroke in pregnancy or postpartum period. Am J Obstet Gynecol. 2016;214:723.e1–11.

    Article  Google Scholar 

  70. Dentali F, Poli D, Scoditti U, Di Minno MN, De Stefano V, Siragusa S, Kostal M, Palareti G, Sartori MT, Grandone E, Vedovati MC, Ageno W, CErebral VEin Thrombosis International Study Investigators, Falanga A, Lerede T, Bianchi M, Testa S, Witt D, McCool K, Bucherini E, Grifoni E, Coalizzo D, Benedetti R, Marietta M, Sessa M, Guaschino C, di Minno G, Tufano A, Barbar S, Malato A, Pini M, Castellini P, Barco S, Barone M, Paciaroni M, Alberti A, Agnelli G, Giorgi Pierfranceschi M, Dulicek P, Silingardi M, Federica L, Ghirarduzzi A, Tiraferri E, di Lazzaro V, Rossi E, Ciminello A, Pasca S, Barillari G, Rezoagli E, Galli M, Squizzato A, Tosetto A. Long-term outcomes of patients with cerebral vein thrombosis: a multicenter study. J Thromb Haemost. 2012;10:1297–302.

    Article  CAS  PubMed  Google Scholar 

  71. Ferro JM, Canhão P, Stam J, Bousser MG, Barinagarrementeria F, ISCVT Investigators. Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke. 2004;35:664–70.

    Article  PubMed  Google Scholar 

  72. Berglund A, Svensson L, Wahlgren N, von Euler M, HASTA Collaborators. Face arm speech time test use in the prehospital setting, better in the ambulance than in the emergency medical communication center. Cerebrovasc Dis. 2014;37:212–6.

    Article  PubMed  Google Scholar 

  73. Mochari-Greenberger H, Xian Y, Hellkamp AS, Schulte PJ, Bhatt DL, Fonarow GC, Saver JL, Reeves MJ, Schwamm LH, Smith EE. Racial/ethnic and sex differences in emergency medical services transport among hospitalized US stroke patients: analysis of the national get with the guidelines-stroke registry. J Am Heart Assoc. 2015;4:e002099.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Berglund A, von Euler M, Schenck-Gustafsson K, Castrén M, Bohm K. Identification of stroke during the emergency call: a descriptive study of callers’ presentation of stroke. BMJ Open. 2015;5:e007661.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Lisabeth LD, Brown DL, Hughes R, Majersik JJ, Morgenstern LB. Acute stroke symptoms: comparing women and men. Stroke. 2009;40:2031–6.

    Article  PubMed  Google Scholar 

  76. Kent DM, Price LL, Ringleb P, Hill MD, Selker HP. Sex-based differences in response to recombinant tissue plasminogen activator in acute ischemic stroke: a pooled analysis of randomized clinical trials. Stroke. 2005;36:62–5.

    Article  CAS  PubMed  Google Scholar 

  77. Nathanson D, Patrone C, Nyström T, von Euler M. Sex, diastolic blood pressure, and outcome after thrombolysis for ischemic stroke. Stroke Res Treat. 2014;2014:747458.

    PubMed  PubMed Central  Google Scholar 

  78. Hill MD, Kent DM, Hinchey J, Rowley H, Buchan AM, Wechsler LR, Higashida RT, Fischbein NJ, Dillon WP, Gent M, Firszt CM, Schulz GA, Furlan AJ, PROACT-2 Investigators. Sex-based differences in the effect of intra-arterial treatment of stroke: analysis of the PROACT-2 study. Stroke. 2006;37:2322–5.

    Article  CAS  PubMed  Google Scholar 

  79. Meseguer E, Mazighi M, Labreuche J, Arnaiz C, Cabrejo L, Slaoui T, Guidoux C, Olivot JM, Abboud H, Lapergue B, Raphaeli G, Klein IF, Lavallée PC, Amarenco P. Outcomes of intravenous recombinant tissue plasminogen activator therapy according to gender: a clinical registry study and systematic review. Stroke. 2009;40:2104–10.

    Article  CAS  PubMed  Google Scholar 

  80. Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, Dávalos A, Majoie CB, van der Lugt A, de Miquel MA, Donnan GA, Roos YB, Bonafe A, Jahan R, Diener HC, van den Berg LA, Levy EI, Berkhemer OA, Pereira VM, Rempel J, Millán M, Davis SM, Roy D, Thornton J, Román LS, Ribó M, Beumer D, Stouch B, Brown S, Campbell BC, van Oostenbrugge RJ, Saver JL, Hill MD, Jovin TG, HERMES Collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723–31.

    Article  PubMed  Google Scholar 

  81. Stroke Unit Trialists’ Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev. 2007;4:CD000197.

    Google Scholar 

  82. Hsue PY, Bittner VA, Betteridge J, Fayyad R, Laskey R, Wenger NK, Waters DD. Impact of female sex on lipid lowering, clinical outcomes, and adverse effects in atorvastatin trials. Am J Cardiol. 2015;115:447–53.

    Article  CAS  PubMed  Google Scholar 

  83. Hedayati N, Humphries MD, Zhou W. Gender and outcomes of carotid artery interventions. Vasc Endovasc Surg. 2014;48:99–105.

    Article  Google Scholar 

  84. Luebke T, Brunkwall J. Meta-analysis and meta-regression analysis of the associations between sex and the operative outcomes of carotid endarterectomy. BMC Cardiovasc Disord. 2015;15:32.

    Article  PubMed  PubMed Central  Google Scholar 

  85. De Rango P, Brown MM, Leys D, Howard VJ, Moore WS, Paciaroni M, Ringleb P, Rockman C, Caso V. Management of carotid stenosis in women: consensus document. Neurology. 2013;80:2258–68.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Buratti L, Balestrini S, Avitabile E, Altamura C, Vernieri F, Viticchi G, Falsetti L, Provinciali L, Silvestrini M. Sex-associated differences in the modulation of vascular risk in patients with asymptomatic carotid stenosis. J Cereb Blood Flow Metab. 2015;35(4):684–8.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal cognitive assessment, MoCa: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.

    Article  PubMed  Google Scholar 

  88. Lin JS, O’Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Screening for cognitive impairment in older adults: a systematic review for the U.S. preventive services task force. Ann Intern Med. 2013;159(9):601–12.

    PubMed  Google Scholar 

  89. Wardlaw JM, Murray V, Berge E, del Zoppo GJ. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev. 2014;7:CD000213.

    PubMed Central  Google Scholar 

  90. Emberson J, Lees KR, Blackwell L, Albers G, et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014;384:1929–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. IST-3 Collaborative Group, Sandercock P, Wardlaw JM, Lindley RI, Dennis M, Cohen G, et al. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet. 2012;379:2352–63.

    Article  Google Scholar 

  92. Reeves M, Bhatt A, Jajou P, Brown M, Lisabeth L. Sex differences in the use of intravenous rt-PA thrombolysis treatment for acute ischemic stroke: a meta-analysis. Stroke. 2009;40:1743–9.

    Article  CAS  PubMed  Google Scholar 

  93. Shobha N, Sylaja PN, Kapral MK, Fang J, Hill MD, Investigators of the Registry of the Canadian Stroke Network. Differences in stroke outcome based on sex. Neurology. 2010;74:767–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Nagaraja N, Bhattacharya P, Mada F, Salowich-Palm L, Hinton S, Millis S, et al. Gender based differences in acute stroke care in Michigan hospitals. J Neurol Sci. 2012;314:88–91.

    Article  PubMed  Google Scholar 

  95. Berglund A, Svensson L, Sjöstrand C, von Arbin M, von Euler M, Wahlgren N, HASTA Collaborators, Engerström L, Höjeberg B, Käll TB, Mjörnheim S, Engqvist A. Higher prehospital priority level of stroke improves thrombolysis frequency and time to stroke unit: the Hyper Acute STroke Alarm (HASTA) study. Stroke. 2012;43:2666–70.

    Article  PubMed  Google Scholar 

  96. Puolakka T, Väyrynen T, Häppölä O, Soinne L, Kuisma M, Lindsberg PJ. Sequential analysis of pretreatment delays in stroke thrombolysis. Acad Emerg Med. 2010;17:965–9.

    Article  PubMed  Google Scholar 

  97. Rothwell PM, Algra A, Chen Z, Diener HC, Norrving B, Mehta Z. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. Lancet. 2016;388:365–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Sandercock PA, Counsell C, Tseng MC, Cecconi E. Oral antiplatelet therapy for acute ischaemic stroke. Cochrane Database Syst Rev. 2014;3:CD000029.

    Google Scholar 

  99. Stroke Unit Trialists’ Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev. 2013;9:CD000197.

    Google Scholar 

  100. Tsivgoulis G, Katsanos AH, Butcher KS, Boviatsis E, Triantafyllou N, Rizos I, Alexandrov AV. Intensive blood pressure reduction in acute intracerebral hemorrhage: a meta-analysis. Neurology. 2014;83:1523–9. Erratum in: Neurology. 2015;84:2466

    Article  PubMed  Google Scholar 

  101. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–67.

    Article  PubMed  Google Scholar 

  102. European Stroke Organisation (ESO) Executive Committee, ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis. 2008;25:457–507.

    Article  Google Scholar 

  103. Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, Halperin JL, Johnston SC, Katzan I, Kernan WN, Mitchell PH, Ovbiagele B, Palesch YY, Sacco RL, Schwamm LH, Wassertheil-Smoller S, Turan TN, Wentworth D, American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American heart association/American stroke association. Stroke. 2011;42:227–76.

    Article  PubMed  Google Scholar 

  104. Howard G, Roubin GS, Jansen O, Hendrikse J, Halliday A, Fraedrich G, Eckstein HH, Calvet D, Bulbulia R, Bonati LH, Becquemin JP, Algra A, Brown MM, Ringleb PA, Brott TG, Mas JL, Carotid Stenting Trialists’ Collaboration. Association between age and risk of stroke or death from carotid endarterectomy and carotid stenting: a meta-analysis of pooled patient data from four randomised trials. Lancet. 2016;387:1305–11.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Science and Education, Karolinska Institutet Stroke Research Network, Södersjukhuset, Stockholm, Sweden

    Mia von Euler M.D., Ph.D.

  2. Section of Neurology, Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden

    Mia von Euler M.D., Ph.D.

  3. Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden

    Mia von Euler M.D., Ph.D.

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  1. Mia von Euler M.D., Ph.D.
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Correspondence to Mia von Euler M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Cardiology, Women’s Cardiac Health Program, Radboud University Medical Center, Nijmegen, The Netherlands

    Angela H.E.M. Maas

  2. Director Barbra Streisand Women’s Heart Center, Linda Joy Pollin Women’s Heart Health Program, Director Preventive Cardiac Center, Cedars-Sinai, Los Angeles, USA

    C. Noel Bairey Merz

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von Euler, M. (2017). Stroke and Cognitive Disorder in Women. In: Maas, A., Bairey Merz, C. (eds) Manual of Gynecardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-54960-6_12

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