Gender differences in presenting and prodromal stroke symptoms.
OBJECTIVE
Prompt recognition of stroke symptoms is critical to timely treatment and women have increased delay to treatment. Women may be more likely to present with atypical symptoms, but this hypothesis has not been extensively evaluated.


METHODS
We examined gender differences in the prevalence of presenting and prodromal stroke symptoms among 1107 consecutive patients hospitalized with neurologist-confirmed acute ischemic stroke. Patient demographics, clinical variables, and stroke symptoms were abstracted from medical records by trained abstractors using standardized forms. Estimates were age-standardized to the age distribution of men and women combined. Presenting symptoms occurred within 24 hours of incident stroke admission; prodromal symptoms occurred >or=24 hours of admission.


RESULTS
Women were significantly older (P<0.001), more likely to have cardioembolic stroke (P<0.01), and less likely to receive aspirin (P=0.014) or statins (P<0.001). Thirty-five percent of the sample (n=389) reported prodromal symptoms. Women were more likely to have >or=1 somatic prodromal and presenting symptoms (P=0.03; P=0.008), but did not differ from men on specific somatic symptoms. Women did not differ from men in classic presenting stroke symptoms (P=0.89).


CONCLUSIONS
Women did not differ significantly in the prevalence of traditional stroke symptoms but were more likely to have somatic presenting and prodromal symptoms. We found no differences in specific prodromal symptoms, making it difficult to craft a public health message about gender differences in early warning signs of stroke. These results suggest that the focus of stroke prevention education for women should continue to emphasize traditional stroke risk factors.
Stuart-Shor
Eileen M
EM
ANP, Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. estuarts@bidmc.harvard.edu
Wellenius
Gregory A
GA
DelloIacono
Donna M
DM
Mittleman
Murray A
MA
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012727:Sex Characteristics; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology*