Davis P
University of Iowa, Iowa City.
Curr Opin Neurol. 1994 Feb;7(1):36-40. doi: 10.1097/00019052-199402000-00007.
Morbidity and mortality rates for stroke are higher in men than women with the exception of subarachnoid hemorrhage. Temporal trends are similar in the two sexes with a slowdown in the decline in mortality rates and a leveling or increase in morbidity rates. Women are more likely than men to have cervical bruits but less likely to have carotid stenosis on ultrasonography. Some factors associated with stroke are unique to women: pregnancy, use of oral contraceptives, postmenopausal hormonal replacement, and choriocarcinoma. Postmenopausal hormonal use is associated with a decreased risk of stroke in observational studies but clinical trials are needed. Control of hypertension and cessation of smoking to reduce the risk of stroke is equally effective in both sexes. Aspirin and ticlopidine are effective in secondary prevention of stroke in women, whereas women may be more sensitive to warfarin than men.
除蛛网膜下腔出血外，男性中风的发病率和死亡率高于女性。两性的时间趋势相似，死亡率下降速度放缓，发病率趋于平稳或上升。女性比男性更易出现颈部血管杂音，但超声检查显示患颈动脉狭窄的可能性较小。一些与中风相关的因素是女性特有的：怀孕、口服避孕药的使用、绝经后激素替代治疗和绒毛膜癌。在观察性研究中，绝经后激素使用与中风风险降低有关，但仍需要临床试验验证。控制高血压和戒烟以降低中风风险在两性中同样有效。阿司匹林和噻氯匹定对女性中风的二级预防有效，而女性对华法林可能比男性更敏感。
