Sex Differences in the Participation in Secondary Prevention Stroke Studies

Area of Science:

• Neurology
• Clinical Trials
• Public Health

Background:

• Women experience higher age-standardized mortality rates for ischemic stroke.
• Despite this, women remain underrepresented in secondary stroke prevention trials.
• This study investigated factors contributing to lower female participation in stroke research.

Purpose of the Study:

• To analyze sex distribution in ischemic stroke patients.
• To identify reasons for underrepresentation of women in secondary stroke prevention trials.
• To compare participation and exclusion factors between sexes in stroke studies.

Main Methods:

• Utilized the population-based Tyrolean Stroke Pathway database for sex distribution analysis.
• Analyzed screening logs from three secondary stroke prevention studies.
• Employed binary and multinomial logistic regression to determine odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

• Women comprised 43.1% of ischemic stroke patients at the study site.
• Older age and higher likelihood of receiving comfort care were noted in screened women.
• Women had increased odds of exclusion due to inability to consent (aphasia, cognitive impairment) and unmet inclusion/exclusion criteria.

Conclusions:

• Female sex is linked to higher exclusion rates from stroke trials, primarily due to comorbidities and neurological deficits.
• Adjusting for age, women did not demonstrate a higher likelihood of refusing study participation compared to men.
• Findings highlight the need to address barriers to women's inclusion in stroke prevention research.