Sex Differences in Causes of Death After Stroke
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Women were 39% more likely to die by 1 year after a first stroke. The sex difference was due to advanced age and more severe strokes in women, according to a new study in the Journal of Women's Health.

Researchers examined sex differences in cause of death and cause-specific excess mortality after stroke.

First-ever strokes participating in the Australian Stroke Clinical Registry were linked to national death registrations and other administrative datasets. One-year cause-specific mortality was categorized as stroke, ischemic heart disease, other cardiovascular disease (CVD; e.g., hypertension), cancer, and other. Specific hazard ratios (sHRs) of death for women compared to men were estimated using competing risk models, with adjustment for factors differing by sex (e.g., age and stroke severity).

-- Among 9,441 cases (46% women), women were 7 years older than men, had more severe strokes, and received similar patterns of suboptimal secondary prevention medications at discharge.

-- Women had greater mortality associated with stroke and other CVD, which was related to age and stroke severity rather than other factors.

-- Compared to population norms, those surviving to 30 days had eight-fold increased mortality from stroke (primary/recurrent) events irrespective of sex.

-- Excess mortality from other CVD was greater in women.

Conclusively, cause-specific mortality after first-ever stroke differs by sex. The greater death rate attributed to stroke/other CVD in women was mostly explained by age and stroke severity. Greater implementation of secondary stroke prevention is relevant to both sexes.