National Clinical Research Centre, Ministry of Health Malaysia, Selangor, Malaysia.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Int J Stroke. 2019 Oct;14(8):826-834. doi: 10.1177/1747493019832995. Epub 2019 Mar 6.
Sex differences in cardiovascular diseases generally disadvantage women, particularly within developing regions.
This study aims to examine sex-related differences in stroke metrics across Southeast Asia in 2015. Furthermore, relative changes between sexes are compared from 1990 to 2015.
Data were sourced from the Global Burden of Disease Study. Incidence and mortality from ischemic and hemorrhagic strokes were explored with the following statistics derived: (1) women-to-men incidence/mortality ratio and (2) relative percentage change in rate.
Women had lower incidence and mortality from stroke compared to men. Notable findings include higher ischemic stroke incidence for women at 30-34 years in high-income countries (women-to-men ratio: 1.3, 95% CI: 0.1, 16.2 in Brunei and 1.3, 95% CI: 0.5, 3.2 in Singapore) and the largest difference between sexes for ischemic stroke mortality in Vietnam and Myanmar across most ages. Within the last 25 years, greater reductions for ischemic stroke metrics were observed among women compared to men. Nevertheless, women below 40 years in some countries showed an increase in ischemic stroke incidence between 0.5% and 11.4%, whereas in men, a decline from -4.2% to -44.2%. Indonesia reported the largest difference between sexes for ischemic stroke mortality; a reduction for women whereas an increase in men. For hemorrhagic stroke, findings were similar: higher incidence among young women in high-income countries and greater reductions for stroke metrics in women than men over the last 25 years.
Distinct sex-specific differences observed across Southeast Asia should be accounted in future stroke preventive guidelines.
心血管疾病中的性别差异通常对女性不利，尤其是在发展中地区。
本研究旨在检验 2015 年东南亚国家中风指标的性别差异。此外，还比较了 1990 年至 2015 年期间男女之间的相对变化。
数据来自全球疾病负担研究。通过以下统计数据探讨了缺血性和出血性中风的发病率和死亡率：（1）女性与男性的发病率/死亡率比；（2）发病率的相对百分比变化。
女性的中风发病率和死亡率低于男性。值得注意的发现包括高收入国家女性在 30-34 岁之间的缺血性中风发病率较高（女性与男性的比例：1.3，95%置信区间：0.1，16.2 在文莱和 1.3，95%置信区间：0.5，3.2 在新加坡），以及越南和缅甸在大多数年龄段之间男女之间缺血性中风死亡率的最大差异。在过去的 25 年中，与男性相比，女性的缺血性中风指标下降幅度更大。然而，在一些国家，40 岁以下的女性缺血性中风发病率在 0.5%至 11.4%之间有所上升，而男性则从-4.2%下降至-44.2%。印度尼西亚报告了男女之间缺血性中风死亡率差异最大；女性下降，而男性上升。对于出血性中风，结果相似：高收入国家年轻女性的发病率较高，在过去的 25 年中，女性的中风指标下降幅度大于男性。
东南亚国家存在明显的性别特异性差异，应该在未来的中风预防指南中加以考虑。
