An analysis of sex-specific risk factors for various types of stroke published recently in JAMA Neurology suggests that many of the risk factors for stroke may be hormone-related.
The 78 studies reviewed were published between 1985 and January 2015, included a total of 10,187,540 participants, and focused on identifying risk factors for ischemic and hemorrhagic stroke, independently, according to a news brief posted on Neurology Times.
The pooled relative risk (RR) of ischemic stroke was higher in women with history of any hypertensive disorder in pregnancy (RR=1.80 [95% confidence interval (CI), 1.49-2.18]) as compared to women without a hypertensive disorder in pregnancy. In men, treatment with androgen deprivation therapy (RR=1.19 [95% CI, 1.05-1.34]) and orchiectomy (RR = 1.21 [95% CI, 1.00-1.46]) increased the relative risk for ischemic stroke, the brief explains.
A history of gestational hypertension was shown to increase the risk of hemorrhagic stroke in women (RR = 5.08 [95% CI, 1.80-14.34]). The risk was also increased in women with menopause at age >55 years (ie, late menopause) vs 50-54 years (RR = 2.24 [95% CI, 1.19-4.21]). Male-specific risk factors for hemorrhagic stroke could not be pooled from the available data, the brief continues.
The brief notes that women with a history of gestational hypertension or who began menopause later than age 55 may have an increased risk of hemorrhagic stroke. Women with gestational hypertension also may have an increased risk of stroke mortality.
In men, however, their stroke risk or mortality could not be determined from the available data.
The brief states also that women with one of the following risk factors were more likely to have a stroke, regardless of its type: oophorectomy, any hypertensive disorder in pregnancy, preterm delivery, and stillbirth. Having a hysterectomy could be mildly protective against stroke. In men, androgen deprivation therapy and erectile dysfunction increased the pooled relative risk of any type of stroke.
[Source: Neurology Times]