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      Sex Dimorphisms in Ischemic Stroke: From Experimental Studies to Clinic

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          Abstract

          Sex dimorphisms are important factors that influence the outcomes after ischemic stroke, which include basic health status, cerebrovascular anatomy, hormone levels, and unique factors such as pregnancy and menopause. It is widely recognized that male and female respond differently to stroke. Women aged 45–74 years old showed a lower risk of stroke incidence compared to age-matched man. This kind of protection is lost with aging. Hence, there is increasing requirement to get a more comprehensive understanding of sex-based factors to stroke on stroke incidence, symptoms, and treatments. This review focuses on sex-specific mechanisms in response to stroke based on experimental studies and highlights recent findings in clinical studies including sex-differential evaluation and outcomes of stroke. Sex-based personalized medicine should be promising in stroke therapies.

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          Global Burden of Stroke.

          Bo Norrving, George Mensah, Valery L. Feigin (2017)
          On the basis of the GBD (Global Burden of Disease) 2013 Study, this article provides an overview of the global, regional, and country-specific burden of stroke by sex and age groups, including trends in stroke burden from 1990 to 2013, and outlines recommended measures to reduce stroke burden. It shows that although stroke incidence, prevalence, mortality, and disability-adjusted life-years rates tend to decline from 1990 to 2013, the overall stroke burden in terms of absolute number of people affected by, or who remained disabled from, stroke has increased across the globe in both men and women of all ages. This provides a strong argument that "business as usual" for primary stroke prevention is not sufficiently effective. Although prevention of stroke is a complex medical and political issue, there is strong evidence that substantial prevention of stroke is feasible in practice. The need to scale-up the primary prevention actions is urgent.
          Article 0 comments Cited 712 times – based on 0 reviews     Review now
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            Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes.

            Mathew Reeves, Cheryl Bushnell, George Howard … (2008)
            Stroke has a greater effect on women than men because women have more events and are less likely to recover. Age-specific stroke rates are higher in men, but, because of their longer life expectancy and much higher incidence at older ages, women have more stroke events than men. With the exception of subarachnoid haemorrhage, there is little evidence of sex differences in stroke subtype or severity. Although several reports found that women are less likely to receive some in-hospital interventions, most differences disappear after age and comorbidities are accounted for. However, sex disparities persist in the use of thrombolytic treatment (with alteplase) and lipid testing. Functional outcomes and quality of life after stroke are consistently poorer in women, despite adjustment for baseline differences in age, prestroke function, and comorbidities. Here, we comprehensively review the epidemiology, clinical presentation, medical care, and outcomes of stroke in women.
            Article 0 comments Cited 360 times – based on 0 reviews     Review now
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              The Reasons for Geographic and Racial Differences in Stroke Study: Objectives and Design

              Virginia Howard, Mary Cushman, LeaVonne Pulley … (2005)
              The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study is a national, population-based, longitudinal study of 30,000 African-American and white adults aged ≧45 years. The objective is to determine the causes for the excess stroke mortality in the Southeastern US and among African-Americans. Participants are randomly sampled with recruitment by mail then telephone, where data on stroke risk factors, sociodemographic, lifestyle, and psychosocial characteristics are collected. Written informed consent, physical and physiological measures, and fasting samples are collected during a subsequent in-home visit. Participants are followed via telephone at 6-month intervals for identification of stroke events. The novel aspects of the REGARDS study allow for the creation of a national cohort to address geographic and ethnic differences in stroke.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Neurol
                Journal ID (iso-abbrev): Front Neurol
                Journal ID (publisher-id): Front. Neurol.
                Title: Frontiers in Neurology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-2295
                Publication date (Electronic): 19 June 2020
                Publication date Collection: 2020
                Volume: 11
                Electronic Location Identifier: 504
                Affiliations
                Brain and Nerve Research Laboratory, Department of Neurosurgery, The First Affiliated Hospital of Soochow University , Suzhou, China
                Author notes

                Edited by: Maurizio Acampa, Siena University Hospital, Italy

                Reviewed by: Simona Lattanzi, Marche Polytechnic University, Italy; Maurice Giroud, Centre Hospitalier Regional Universitaire De Dijon, France

                *Correspondence: Qing Sun qsun@ 123456suda.edu.cn

                This article was submitted to Stroke, a section of the journal Frontiers in Neurology

                †These authors have contributed equally to this work

                Article
                DOI: 10.3389/fneur.2020.00504
                PMC ID: 7318992
                PubMed ID: 32636794
                SO-VID: aa396e3a-77e8-4d42-b5c1-4b91f9f85646
                Copyright © Copyright © 2020 Jiang, Ma, Li, Shen, Li, Sun and Chen.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 07 March 2020
                Date accepted : 07 May 2020
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 84, Pages: 7, Words: 6294
                Categories
                Subject: Neurology
                Subject: Review

                ScienceOpen disciplines: Neurology
                Keywords: sex differences,stroke,hormone,mechanism,clinic,evaluation,tpa
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: sex differences, stroke, hormone, mechanism, clinic, evaluation, tpa

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