title: The gender gap in stroke: a meta-analysis.
abstract: Several studies have indicated that gender differences might exist in stroke.
  
  
  OBJECTIVE
  Our goal was to perform a comprehensive meta-analysis in order to evaluate and quantify stroke gender disparities through a systematic search of relevant articles published up to October 2009 and addressing gender related differences in ischemic stroke risk factors, stroke subtype and severity, diagnostic tests, and acute phase and secondary prevention treatments.
  
  
  RESULTS
  Forty-five articles were included in the analysis, representing a total of 673,935 patients. Women were globally older than men (+5.2 years) and suffered more hypertension (P = 0.017) and atrial fibrillation (P < 0.001), although they were less likely to drink alcohol (P < 0.001), smoke cigarettes (P < 0.001), present hyperlipidemia (P = 0.033) or diabetes (P = 0.003) than men. Baseline stroke severity was not different between genders. Women suffered more cardioembolic strokes, while men had more atherothrombotic strokes. Moreover, women were less likely to receive stroke-related treatments, such as antiplatelets (P < 0.001), statins (P < 0.001), and tPA (P < 0.001) than men. Although meta-regression did not identify age or stroke etiology as sources of heterogeneity, caution should be taken as that analysis was possible only for gender differences in secondary prevention with antiplatelets because of limited data for other end points.
  
  
  CONCLUSIONS
  Gender differences have been identified on the risk factors profile and diagnostic and therapeutic management of patients with ischemic stroke. Active measures should thus be taken to avoid bias in clinical practice.
authors.affiliation: Neurovascular Research Laboratory and Neurovascular Unit, Neurology and Medicine Departments, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital Research Institute, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Giralt
authors.forename: S
authors.initials: S
authors.lastname: Domingues-Montanari
authors.forename: M
authors.initials: M
authors.lastname: Mendioroz
authors.forename: L
authors.initials: L
authors.lastname: Ortega
authors.forename: O
authors.initials: O
authors.lastname: Maisterra
authors.forename: M
authors.initials: M
authors.lastname: Perea-Gainza
authors.forename: P
authors.initials: P
authors.lastname: Delgado
authors.forename: A
authors.initials: A
authors.lastname: Rosell
authors.forename: J
authors.initials: J
authors.lastname: Montaner
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000209:etiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000209:etiology; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012906:Smoke / Q000009:adverse effects; D020521:Stroke / Q000145:classification / Q000150:complications / Q000209:etiology*
chemical_list: D012906:Smoke