Petrea Rodica E, Beiser Alexa S, Seshadri Sudha, Kelly-Hayes Margaret, Kase Carlos S, Wolf Philip A
Department of Neurology, Boston University School of Medicine, Boston, MA 02118-2526, USA.
Stroke. 2009 Apr;40(4):1032-7. doi: 10.1161/STROKEAHA.108.542894. Epub 2009 Feb 10.
Stroke is emerging as a major public health problem for women, as it is for men. Controversy persists regarding gender differences in stroke incidence, severity, and poststroke disability.
Participants in the Framingham Original (n=5119; 2829 women) and Offspring (n=4957, 2565 women) cohorts who were 45 years and stroke-free were followed to first incident stroke. Gender-specific outcome measures were adjusted for the Framingham Stroke Risk Profile components.
We observed 1136 incident strokes (638 in women) over 56 years of follow-up. Women were significantly (P<0.001) older (75.1 versus 71.1 years for men) at their first-ever stroke, had a higher stroke incidence above 85 years of age, lower at all other ages, and a higher lifetime risk of stroke at all ages. There was no significant difference in stroke subtype, stroke severity, and case fatality rates between genders. Women were significantly (P<0.01) more disabled before stroke and in the acute phase of stroke in dressing (59% versus 37%), grooming (57% versus 34%), and transfer from bed to chair (59% versus 35%). At 3 to 6 months poststroke women were more disabled, more likely to be single, and 3.5 times more likely to be institutionalized (P<0.01).
These results from the Framingham Heart Study (FHS) support the existence of gender-differences in stroke incidence, lifetime risk (LTR) of stroke, age at first stroke, poststroke disability, and institutionalization rates. Prestroke disability and sociodemographic factors may contribute to the high rate of institutionalization and poorer outcome observed in women.
中风正成为女性面临的一个主要公共卫生问题，对男性而言亦是如此。关于中风发病率、严重程度及中风后残疾方面的性别差异，争议依然存在。
弗雷明汉姆原队列研究（n = 5119；2829名女性）和子代队列研究（n = 4957，2565名女性）中45岁且无中风病史的参与者被随访至首次发生中风。针对弗雷明汉姆中风风险概况各组成部分，对特定性别的结局指标进行了调整。
在56年的随访期间，我们观察到1136例首次中风病例（女性638例）。女性首次中风时年龄显著更大（P < 0.001）（男性为71.1岁，女性为75.1岁），85岁以上女性中风发病率更高，其他所有年龄段则较低，且各年龄段女性中风终生风险更高。中风亚型、中风严重程度及病死率在性别之间无显著差异。中风前及中风急性期，女性在穿衣（59%对37%）、修饰（57%对34%）以及从床转移至椅子（59%对35%）方面的残疾程度显著更高（P < 0.01）。中风后3至6个月，女性残疾程度更高，更可能单身，且被送进养老院的可能性高3.5倍（P < 0.01）。
弗雷明汉姆心脏研究（FHS）的这些结果支持在中风发病率、中风终生风险（LTR）、首次中风年龄以及中风后残疾和进养老院比率方面存在性别差异。中风前残疾及社会人口学因素可能导致女性中观察到的高进养老院率和较差结局。
