title: Persistent sex disparity in midlife stroke prevalence in the United States.
abstract: BACKGROUND
  A recent study found that US women aged 45-54 years in 1999-2004 were twice as likely as men to report previous stroke. The aim of this study was to evaluate the validity of this finding by assessing the sex-specific midlife stroke prevalence in the most recent nationally representative, cross-sectional sample of US individuals.
  
  
  METHODS
  Sex-specific stroke prevalence, sex-specific vascular risk factor prevalence and sex-specific independent predictors of stroke were assessed among 35- to 64-year olds who participated in the National Health and Nutrition Examination Surveys in 2005-2006 (n = 2,274).
  
  
  RESULTS
  Women aged 35-64 years were almost 3 times more likely than men to report prior stroke (2.90 vs. 1.07%; p < 0.001). This disparity was driven by the 45- to 54-year age group, where women had thrice the odds of prior stroke compared with men (OR 3.12, 95% CI 1.30-7.50). Among 45- to 54-year olds, men were more likely than women to have a history of smoking, elevated homocysteine and elevated triglyceride levels, but less likely to be abdominally obese (p < 0.001). Independent stroke risk factors among women aged 35-64 years were a homocysteine level >8.5 μmol/l (OR 6.19, 95% CI 2.57-14.93), a history of myocardial infarction (OR 5.35, 95% CI 1.09-26.27) and diabetes mellitus (OR 6.63, 95% CI 2.47-17.81).
  
  
  CONCLUSIONS
  The midlife sex disparity in US stroke prevalence persists. Greater emphasis on prompt recognition and treatment of cardiovascular risk factors among young and middle-aged women may ameliorate this worrisome trend.
authors.affiliation: Department of Neurology, University of Southern California, Los Angeles, 90033, USA. towfighi@usc.edu
authors.forename: Amytis
authors.initials: A
authors.lastname: Towfighi
authors.forename: Daniela
authors.initials: D
authors.lastname: Markovic
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011314:Preventive Health Services; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology