Women have worse quality of life than do men up to 12 months after stroke, researchers found even after adjusting for important sociodemographic variables, stroke severity and disability.


In the study, reported in Neurology, quality of life was assessed three and 12 months postdischarge in 1,370 patients (53.7% male; median age 65 years) who had been treated for ischemic stroke or transient ischemic attack (TIA).

Women were found to have significantly lower quality of life at both points, faring worse in the dimensions of mobility, pain/discomfort and anxiety/depression. Quality of life remained lower for women than for men after multivariable adjustment for sociodemographic, clinical and stroke-related factors. 


“As more people survive strokes, physicians and other health-care providers should pay attention to quality-of-life issues and work to develop better interventions, even gender-specific screening tools, to improve these patients’ lives,” noted Cheryl Bushnell, MD, associate professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, N.C., and senior author of the study, in a statement issued by Wake Forest Baptist.


Bushnell also authored the newly released Guidelines for the Prevention of Stroke in Women: a Statement for Healthcare Professionals from the American Heart Association/American Stroke Association, (available from the journal Stroke at stroke.ahajournals.org/content/early/2014/02/06/01.str.0000442009.06663.48.full.pdf+html; accessed February 15, 2014). This scientific statement also calls for the development of a female-specific stroke risk score. 


High BP, migraine with aura, atrial fibrillation, diabetes, depression and emotional stress tend to be stronger risk factors for stroke in women than in men. For example, according to the guidelines:


  • Women should be screened for high BP before initiating oral contraceptive use, as the combination raises the risk of stroke.

  • Women with a history of high BP before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower their risk for preeclampsia.

  • Women who have migraine headaches with aura should stop smoking to avoid higher stroke risk. 

  • Women aged 75 years and older should be screened for atrial fibrillation risks due to this condition’s association with heightened stroke risk. 


References

Bushnell C et al. Stroke. 2014; doi: 10.1161/01.str.0000442009.06663.48.