From the Research
The average age of onset for ischemic stroke is approximately 68-70 years in men and 72-75 years in women. Women typically experience their first stroke about 4-5 years later than men. This gender difference is partly attributed to the protective effects of estrogen in pre-menopausal women, which helps maintain healthier blood vessels and better lipid profiles 1. After menopause, when estrogen levels decline, women's stroke risk increases significantly. Men tend to develop risk factors like hypertension, diabetes, and atherosclerosis earlier in life, contributing to their earlier stroke onset. Additionally, lifestyle factors such as higher rates of smoking and alcohol consumption among men historically have played a role in this gender disparity.
Some key points to consider:
- The frequency of hypertension, hyperlipidemia, and diabetes mellitus increases with age among all stroke subtypes, whereas smoking decreases with age 2.
- Younger patients with ischemic stroke have different risk factors and etiologies, and fewer co-morbidities compared to older patients 3.
- Diabetes is associated with increased risk of ischemic stroke, although this risk declines with age, and at a lower rate among women than men 1.
- It's essential to recognize that stroke risk increases substantially with age for both genders, with the highest incidence occurring in those over 65 years old.
- Early recognition of stroke symptoms and management of modifiable risk factors like hypertension, diabetes, smoking, and physical inactivity can help reduce stroke risk regardless of gender.
Overall, the management of ischemic stroke should prioritize the reduction of modifiable risk factors, particularly in older adults, to minimize the risk of stroke and improve outcomes 4, 5.