Persistent sex disparity in midlife stroke prevalence in the United States

Cerebrovasc Dis. 2011;31(4):322-8. doi: 10.1159/000321503. Epub 2011 Jan 7.

Abstract

Background: A recent study found that US women aged 45-54 years in 1999-2004 were twice as likely as men to report previous stroke. The aim of this study was to evaluate the validity of this finding by assessing the sex-specific midlife stroke prevalence in the most recent nationally representative, cross-sectional sample of US individuals.

Methods: Sex-specific stroke prevalence, sex-specific vascular risk factor prevalence and sex-specific independent predictors of stroke were assessed among 35- to 64-year olds who participated in the National Health and Nutrition Examination Surveys in 2005-2006 (n = 2,274).

Results: Women aged 35-64 years were almost 3 times more likely than men to report prior stroke (2.90 vs. 1.07%; p < 0.001). This disparity was driven by the 45- to 54-year age group, where women had thrice the odds of prior stroke compared with men (OR 3.12, 95% CI 1.30-7.50). Among 45- to 54-year olds, men were more likely than women to have a history of smoking, elevated homocysteine and elevated triglyceride levels, but less likely to be abdominally obese (p < 0.001). Independent stroke risk factors among women aged 35-64 years were a homocysteine level >8.5 μmol/l (OR 6.19, 95% CI 2.57-14.93), a history of myocardial infarction (OR 5.35, 95% CI 1.09-26.27) and diabetes mellitus (OR 6.63, 95% CI 2.47-17.81).

Conclusion: The midlife sex disparity in US stroke prevalence persists. Greater emphasis on prompt recognition and treatment of cardiovascular risk factors among young and middle-aged women may ameliorate this worrisome trend.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Preventive Health Services
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Stroke / epidemiology*
  • Stroke / prevention & control
  • United States / epidemiology