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Stroke is a leading cause of death and disability worldwide. Although the age standardized rates of stroke have fallen, the absolute number of strokes continue to rise, particularly in the low and middle income countries. It was long recognized that women have a lower age-standardized incidence of stroke. This understanding has been challenged by the Global burden of Disease Study 2019 which highlights that although the total number of Disability Adjusted Life Years (DALYs) from stroke were higher in males compared to females, the number of incident and prevalent strokes were higher in females. In addition, the study did not find significant difference in the age-standardized incidence rates between males and females.1 Yet another study recently found that beyond 75 years of age women have a higher stroke incidence compared to men.2 Additionally, women below 40 years in some South East Asian countries showed an increase in ischemic stroke incidence from 0.5% to 11.4% between 1990 and 2015.3 This finding is duplicated in other studies, and a recent systematic review concluded that there were 44% more women than men with ischemic stroke in the under 35 years age group.4 Risk of aneurysmal rupture has also recently been shown to be higher in women compared to their male counterparts.

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