Sex, diastolic blood pressure, and outcome after thrombolysis for ischemic stroke
Related Experiment Video
Updated: Apr 22, 2026
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
David Nathanson1, Cesare Patrone1, Thomas Nyström1
1Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden ; Department of Internal Medicine, Sjukhusbacken 10 Södersjukhuset, 118 83 Stockholm, Sweden ; Karolinska Institutet Stroke Research Network at Södersjukhuset, Stockholm, Sweden.
Insights
Women with ischemic stroke may benefit more from thrombolysis than men. Higher diastolic blood pressure is linked to worse outcomes in men receiving this stroke treatment.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Ischemic stroke is a leading cause of disability worldwide.
- Thrombolytic therapy is a critical treatment for acute ischemic stroke.
- Understanding sex-based differences in stroke treatment outcomes is crucial for personalized medicine.
Purpose of the Study:
- To investigate sex-specific differences in risk factors and functional outcomes following thrombolysis for ischemic stroke.
- To identify factors influencing recovery in male and female stroke patients.
Main Methods:
- A retrospective cohort study analyzed data from 355 patients treated with thrombolysis for ischemic stroke over three years.
- Patient demographics, clinical characteristics, and functional status (modified Rankin Scale) were assessed at admission and three months post-discharge.
Main Results:
- Women were older (median 76 vs. 69 years) and had lower diastolic blood pressure than men.
- Fewer women presented with a favorable modified Rankin Scale score at admission compared to men (93.8% vs. 99%).
- No significant difference in functional status was observed between sexes at three months post-discharge. Diastolic blood pressure was associated with poorer outcomes in men (OR 5.7).
Conclusions:
- Females may experience a greater relative benefit from thrombolytic therapy, indicated by better functional recovery.
- Elevated diastolic blood pressure is a risk factor for worse functional status in men post-thrombolysis.
- Sex-specific considerations may optimize thrombolytic therapy for ischemic stroke patients.
Abstract:
Background. The goal of this study was to identify differences in risk factors and functional outcome between the two sexes in patients treated with thrombolysis for ischemic stroke. Methods. This cohort study audited data from patients treated with thrombolysis for ischemic stroke during a 3-year period at Södersjukhuset, Stockholm. Results. Of the 355 patients included in the study, 162 (45%) were women and 193 (54%) were men. Women were older with a median age of 76 years; median age for men was 69 years (P < 0.0001). Diastolic blood pressure was lower for women compared to men (P = 0.001). At admission fewer women had a favorable modified Rankin Scale score compared to men (93.8% versus 99%, P = 0.008). Three months after discharge functional status did not differ significantly between the two sexes. Diastolic blood pressure was associated to functional outcome only in men when sex specific odds ratios were calculated (OR, 5.7; 95% CI, 1.7-20). Conclusion. The study indicates that females appear to gain a relatively greater benefit from thrombolytic therapy than men due to a better functional recovery. A higher diastolic blood pressure increases the risk for a worse prospective functional status in men.
Related Concept Videos
01:15Ischemic Stroke ll: Pathophysiology
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:23Assessment of blood pressure in brachial artery(two-step method)
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:17Measurement of Blood Pressure