Studies in the early 2000s showed that women were 30% less likely to receive clot-busting treatment for a stroke than men. However, an analysis of recent studies, published in the June 10, 2020 online issue of Neurology, found there has been a 17% increase for woman receiving treatment. This narrowed the treatment gap from 30% to 13%.
The earlier studies examined data from thrombolysis, published from 2000 to 2008, and the new analysis reviewed 24 studies of more than 1 million individuals with stroke published between 2008 and 2018.
A reason for the difference between men and women may be that women are much more likely to live alone, so they may arrive later at the hospital. Also, they might be unaware of when their symptoms started, compared with individuals who live with a partner. Another reason may be that stroke in women can lead to atypical symptoms such as loss of alertness, weakness, or incontinence, so the diagnosis may be more complicated or take more time.
“We are heartened that this treatment gap has narrowed, but more research is definitely needed into why a gap persists and whether it is continuing to get smaller,” said Mathew Reeves, PhD, Michigan State University. “This is especially important as additional treatments for acute stroke are developed and implemented. Most of the studies showed differences of 0.5% to 1.0%. The largest difference in one study was 8.4%. Still, even small differences could translate into many untreated women, given how common stroke is in the elderly population. These missed opportunities have greater consequences for women since they tend to have more serious disability and are more likely to die after a stroke than men, but importantly, have been shown to benefit just as much from treatment as men do.”
Nidhiben Anadani, MD
David Z. Rose, MD