title: A midlife stroke surge among women in the United States.
abstract: BACKGROUND
  We assessed sex differences in stroke prevalence among individuals of midlife age (35 to 64 years) in the United States and determined factors predicting stroke.
  
  
  METHODS
  Data from 1999 to 2004 (n = 17,061) from the National Health and Nutrition Examination Survey, a nationally representative sample of US adults, were used to assess sex differences in stroke prevalence and to identify independent predictors of stroke occurrence among middle-aged individuals.
  
  
  RESULTS
  Women aged 45 to 54 years had significantly higher odds of having experienced a stroke vs men of the same age (odds ratio [OR] 2.39, 95% CI 1.32 to 4.32). No other significant midlife stroke differences between sexes were noted. A higher stroke trend was seen in 45- to 54-year-old women vs 35- to 44-year-old women (OR 2.13, 95% CI 0.95 to 4.80, p = 0.067), but no difference was seen in stroke rates in 55- to 64-year-old women vs 45- to 54-year-old women (OR 1.40, 95% CI 0.6912 to 2.8229, p = 0.352). Independent predictors of stroke in women aged 45 to 54 years were coronary artery disease (OR 12.790, 95% CI 1.901 to 86.063, p = 0.009) and waist circumference (OR 1.543, 95% CI 1.002 to 2.376, p = 0.049). Several vascular risk factors including systolic blood pressure and total cholesterol levels increased at higher rates among women compared with men in each successively older cohort from 35 to 64 years.
  
  
  CONCLUSIONS
  A higher prevalence of stroke may exist among women aged 45 to 54 years compared with similarly aged men. This potential disparity could be due in part to inadequate stroke risk factor modification in women and is deserving of further study.
authors.affiliation: Stroke Center and Department of Neurology, University of California at Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA. towfighi@usc.edu
authors.forename: Amytis
authors.initials: A
authors.lastname: Towfighi
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Saver
authors.forename: Rita
authors.initials: R
authors.lastname: Engelhardt
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012727:Sex Characteristics; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D049629:Waist-Hip Ratio / Q000379:methods