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    Area of Science:

    • Neurology
    • Cardiovascular Science
    • Public Health

    Background:

    • Stroke affects men and women differently in terms of risk factors and outcomes.
    • Historically, women were thought to have worse stroke outcomes, but this is now better understood through comprehensive analysis.

    Purpose of the Study:

    • To review and highlight the sex differences in stroke risk factors and presentation.
    • To emphasize the unique risk factors women face across their lifespan.

    Main Methods:

    • Review of prior studies, meta-analyses, and large cohort studies.
    • Analysis of reproductive and non-reproductive risk factors for stroke in women.
    • Comparison of stroke risk and outcomes between sexes.

    Main Results:

    • Age, prestroke functional status, and comorbidities explain many sex differences in stroke severity, outcomes, and mortality.
    • Female-specific risk factors include fewer years between menarche and menopause, pregnancy complications, oophorectomy, hormone therapy, and early menopause.
    • Key stroke risks with greater impact on women include age, hypertension, atrial fibrillation, socioeconomic status, and depression.

    Conclusions:

    • Significant sex differences exist in stroke risk factors and outcomes.
    • Incorporating sex-specific information into clinical assessments can improve stroke prevention strategies.