Study: Women Aged 35 and Younger Are 44% More Likely Than Men to Have Strokes

Investigators say more research is needed to better define the etiological sex differences in young adults and the contributions of nontraditional risk factors.

Among adults aged 35 years or younger, women are 44% more likely than men to suffer ischemic strokes, according to the results of a study conducted by faculty members from the University of Colorado’s School of Medicine.1

In the study, Sharon Poisson, MD, and Michelle Leppert, MD, both from the department of neurology at the university, looked at just the occurrences of the strokes that are caused by blood clots that travel to the brain, not what caused them.1

“More research is needed to better define the etiological sex differences of ischemic stroke in young adults and the contributions that nontraditional risk factors, such as pregnancy, postpartum, and hormonal contraceptives, play in the overall burden of ischemic strokes in young women,” they said in a statement.1

Leppert conducted a large administrative study that included papers where she initially found this difference. The investigators then decided to combine 19 studies for a larger data pool.1,2

In the analysis, the investigators found that 9 of the studies did not have any significant sex difference among adults younger than aged 45 years. The studies contained overlapping data. However, 3 studies showed higher rates of ischemic strokes among men between aged 30 and 35 years.2

Additionally, 4 studies showed more women with ischemic strokes among adults younger than aged 35 years.2

Overall, investigators found that the estimated effect size for adults younger than aged 35 years favored more ischemic strokes in women.2

Additionally, in their conclusion, investigators found that this gap narrows in adults aged 35 to 45 years of age, and there is conflicting evidence as to whether more men or women experience ischemic strokes in this age range.2

For the study, investigators searched PubMed, a database for biomedical literature hosted by the National Institutes of Health, for articles and reviews that related to their study published between January 2008 and July 2021.2

They included studies that were population based, reported stroke incidence by sex or sex-specific incidence rate ratios of adults younger than aged 45 years. They excluded studies that omitted age adjustments, omitted measurements of error for incident rates or rate ratios, and were not in English.2

Statistical synthesis was used to estimate sex differences by age groups and stroke type.2

“The next step, now that we see that there is a difference in stroke incidence in young women versus young men, is to conduct a more detailed clinical study where we’re able to collect more detailed information about each of these strokes,” Poisson said.1

Additionally, she said that more work should be done to determine what causes this gap in strokes, adding that it is important to understand the issues in the initial study, so that other studies can be designed to fix these issues.1

References

1. In young people, women are 44% more likely than men to have strokes. EurekAlert. News release. February 3, 2022. Accessed February 4, 2022. https://www.eurekalert.org/news-releases/942351

2. Leppert MH, Burke JF, Lisabeth LD, et al. Systematic review of sex differences in ischemic strokes among young adults: are young women disproportionately at risk? Stroke. 2022;53(2):319-327. doi:10.1161/STROKEAHA.121.037117