title: Stroke incidence, prevalence and mortality in women worldwide.
abstract: BACKGROUND
  The study of sex differences on stroke incidence, prevalence and mortality is an emerging field of stroke epidemiology and care.
  
  
  OBJECTIVE
  This study sought to determine the information available on stroke epidemiology in women worldwide and possible sex differences in stroke epidemiology, and, if so, describe the nature of these differences and whether they are consistent across countries/groups of countries.
  
  
  CONCLUSIONS
  We searched the available literature in English published between 1 January 2008 and 5 May 2015. Out of 17.789 papers only 56 peer-reviewed papers (29 community-based studies, 17 retrospective studies, 6 reviews, and 4 cross-sectional studies) have been included in the study. This review adopted the epidemiologic transition theory, which classifies countries into four stages according to their levels of industrialization and economy. For the first and second stages, reliable registries and health certification are lacking, and therefore our sought after data were very limited.In the third stage, specifically for Eastern Europe (post-socialist countries), the burden from stroke in women was on the rise, while in the fourth stage, despite an aging population, decreases in stroke incidence, prevalence and mortality have been observed, even in subjects older than 80 years for both sexes. However, regarding studies of US populations, these trends for women were less pronounced for African Americans, and Hispanics as well as Indians. This suggests a "gender-gap" regarding access to treatment and care.In conclusion, identifying the presence of differing global burden between the sexes will allow us to better understand how to prevent, treat, and manage both men and women.
authors.affiliation: Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Arnao
authors.affiliation: Stroke Unit and Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Acciarresi
authors.affiliation: Wandworth Complex Needs Servise, South West London and ST George's Hospital Building 1 Entrance C, London, UK.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Cittadini
authors.affiliation: Stroke Unit and Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy vcaso@hotmail.com.
authors.forename: Valeria
authors.initials: V
authors.lastname: Caso
mesh_terms: D000367:Age Factors; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality; D016019:Survival Analysis
keywords: Females; epidemiology; incidence; mortality; prevalence; stroke