Why do women have a higher stroke hospitalization risk than men?

Why do women have a higher stroke hospitalization risk than men?

The list of disparities between men and women is long. But a new study reveals that women are more likely to be hospitalized for stroke than men. Researchers say their results may have implications for allocating resources and policy decisions.

The study finds that the reason women have a higher stroke hospitalization risk than men is not down to biology.

"There is a debate about whether it's the biology and something naturally in women that predisposes them to stroke or whether healthcare providers are failing to give adequate care," says Dr. Ghanshyam Shantha, cardiovascular disease fellow at the University of Iowa Hospitals and Clinics in Iowa City.

He will present the new study today at CARDIOSTIM EHRA EUROPACE 2016, an international conference taking place in Nice, France.

According to Dr. Shantha, evidence from around the world indicates that women with atrial fibrillation (AF) receive less treatment for stroke prevention than they need; while 60 percent of men who should receive anticoagulation get it, only 30 percent of women do.

AF is an irregular heartbeat that can result in blood clots, stroke, heart failure, and other complications. According to the American Heart Association, an estimated 2.7 million Americans live with AF today.

Approximately 15-20 percent of people who have strokes have AF. In fact, AF doubles the risk of heart-related deaths and causes a fourfold to fivefold increased stroke risk, yet many people with AF are not aware that it is a serious condition.

'Gender discrepancy not due to biology'

Dr. Shantha notes that it is already known that women do not get advanced AF treatments at the same level as men, but he adds that what is unknown "is whether these deficiencies in access to care translate into poorer outcomes."

As such, the new study looked at whether gender affected the rate of hospitalization for ischaemic stroke in patients with AF.

Using data from the National Inpatient Sample - which has data from 1998-2012 on 8 million patients admitted to 1,000 hospitals in 46 states - the researchers examined 1.1 million patients who were admitted to the hospital with diagnosed AF.

During the 15-year period, the rate of stroke hospitalization in patients with AF was 2.64 percent in women and 2.15 percent in men.

Results showed that, after adjusting for stroke risk factors such as age, diabetes, hypertension, previous stroke, and heart failure, women had a 23 percent higher risk of stroke hospitalization than men.

Interestingly, although treatments for AF have improved over the last 15 years, the researchers found that women consistently had a higher stroke hospitalization risk than men. In 1998-2002, women had a 27 percent higher risk; in 2003-2007, they had a 23 percent higher risk; and in 2008-2012, they had a 22 percent higher risk.

Additionally, the team found that women had a higher stroke risk compared with men, regardless of age, ethnicity, socioeconomic status, or region. "However you slice, dice, and divide the data, women do poorer than men in terms of admissions for acute ischemic stroke," says Dr. Shantha.

Our findings findings corroborate the previous evidence that women receive less treatment and support the conclusion that the gender discrepancy is due to inadequate stroke prevention care in women and not biology."

Dr. Ghanshyam Shantha

He adds that their results have significance for policy decisions and resource allocation, though he calls for more research "on why many women do not get evidence-based care."

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Section Issues On Medicine: Disease