Falsetti Lorenzo, Viticchi Giovanna, Buratti Laura, Balucani Clotilde, Marra Alberto M, Silvestrini Mauro
Internal and Sub-intensive Medicine Department, A.O.U. "Ospedali Riuniti", Ancona, Italy; University of Bologna, Cardio-Nephro-Thoracic Sciences PhD School, Italy.
Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
Pharmacol Res. 2017 Jul;121:240-250. doi: 10.1016/j.phrs.2017.05.006. Epub 2017 May 12.
Stroke is a major cause of mortality and morbidity, particularly in the older ages. Women have a longer life expectancy and are more likely to experience stroke than men. Interestingly, the increased risk of ischemic stroke in women seems to be independent from age or classical cardiovascular risk factors. Notwithstanding the fact that stroke outcomes and survival are usually poorer in women, current evidence suggests that thrombolysis, antiplatelet and anticoagulant therapies are more beneficial in women than in men. A possible explanation of this paradox might be that females are often undertreated and they have fewer chances to be submitted to an effective and timely treatment for stroke than the male counterpart. The first step in the attempt to solve this obvious discrimination is surely to emphasize any reasons for differences in the therapeutic approach in relation to gender and then to denounce the lack of a sustainable motivation for them. In this article, we aimed to review the existing literature about gender-related differences on efficacy, administration and side effects of the most common drugs used for the treatment of ischemic stroke. The most striking result was the evidence that the therapeutic approach for stroke is often different according to patients' gender with a clear detrimental prognostic effect for women. A major effort is necessary to overcome this problem in order to ensure equal right to treatment without any sexual discrimination.
中风是导致死亡和发病的主要原因，在老年人中尤为如此。女性预期寿命更长，比男性更易患中风。有趣的是，女性缺血性中风风险增加似乎与年龄或经典心血管危险因素无关。尽管女性中风的预后和生存率通常较差，但目前证据表明，溶栓、抗血小板和抗凝治疗对女性比男性更有益。这种矛盾现象的一个可能解释是，女性往往治疗不足，与男性相比，她们接受有效及时中风治疗的机会更少。试图解决这种明显歧视的第一步肯定是强调治疗方法在性别方面存在差异的任何原因，然后谴责缺乏对此的可持续动机。在本文中，我们旨在回顾现有关于治疗缺血性中风常用药物在疗效、给药和副作用方面性别差异的文献。最显著的结果是有证据表明，中风的治疗方法往往因患者性别而异，对女性有明显不利的预后影响。为确保平等的治疗权利而不受任何性别歧视，必须做出重大努力来克服这个问题。
