University of Lille, INSERM U1171, Degenerative &vascular cognitive disorders, Centre Hospitalier Universitaire, Department of Neurology, F-59000 Lille, France.
Division of Clinical Neurosciences, University of Nottingham, Hucknall Road, NG5 1PB, UK.
Nat Rev Neurol. 2017 Sep;13(9):521-532. doi: 10.1038/nrneurol.2017.95. Epub 2017 Jul 21.
Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke - including diabetes mellitus and atrial fibrillation - are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy. However, in an era of evidence-based medicine, women are notably under-represented in clinical trials - despite governmental actions highlighting the need to include both men and women in clinical trials - resulting in a reduced generalizability of study results to women. The aim of this Review is to highlight new insights into specificities of stroke in women, to plan future research priorities, and to influence public health policies to decrease the worldwide burden of stroke in women.
中风是全球导致伤残调整生命年（DALY）损失的第二大原因。由于全球女性人口的平均年龄不断上升，预计女性中风的患病率将迅速上升。在患病率方面，血管危险因素在女性和男性之间存在差异，越来越多的证据支持中风性别差异的临床重要性。一些中风风险因素——包括糖尿病和心房颤动——在女性中更为常见，妊娠高血压疾病也会在妊娠后数十年内影响中风的风险。然而，在循证医学时代，女性在临床试验中的代表性明显不足——尽管政府采取行动强调需要将男性和女性都纳入临床试验——导致研究结果对女性的普遍适用性降低。本综述的目的是强调女性中风特殊性的新见解，规划未来的研究重点，并影响公共卫生政策，以降低全球女性中风负担。
