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This Article Full Text Full Text (PDF) CME: Take the course for this article: Volume 69, Number 20, November 13, 2007 All Versions of this Article: 01.wnl.0000268491.89956.c2v1 69/20/1898    most recent Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in Neurology Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Towfighi, A. Articles by Ovbiagele, B. Search for Related Content PubMed PubMed Citation Articles by Towfighi, A. Articles by Ovbiagele, B. Related Collections Outcome research All Cerebrovascular disease/Stroke Stroke in young adults Other cerebrovascular disease/ Stroke All epidemiology Prevalence studies Risk factors in epidemiology

A midlife stroke surge among women in the United States

From the Stroke Center and Department of Neurology (A.T., J.L.S., B.O.) and Department of Biomathematics (R.E.), UCLA Medical Center, Los Angeles, California.

Address correspondence and reprint requests to Dr. Amytis Towfighi, Stroke Center and Department of Neurology, University of California at Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095 towfighi{at}usc.edu

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.

GLOSSARY: ABPI = ankle–brachial pressure index; CAD = coronary artery disease; DM = diabetes mellitus; NHANES = National Health and Nutrition Examination Survey.

Editorial, see page 1894

e-Pub ahead of print on June 20, 2007, at www.neurology.org.

Disclosure: The authors report no conflicts of interest.

Received January 7, 2007. Accepted in final form April 16, 2007.

Related articles in Neurology:

Sex and stroke: Are they really different in midlife?

Kevin M. Barrett and Bradford B. Worrall
Neurology 2007 69: 1894-1895. [Full Text]  

This article has been cited by other articles:

				Midlife Stroke Disparity in U.S. Women vs. Men? Journal Watch Neurology, January 29, 2008; 2008(129): 1 - 1. [Full Text]

				K. M. Barrett and B. B. Worrall Sex and stroke: Are they really different in midlife? Neurology, November 13, 2007; 69(20): 1894 - 1895. [Full Text] [PDF]