By Karla Gale
NEW YORK (Reuters Health) Jan 02 - Women have better chances of surviving a stroke than men, and female stroke survivors tend to live longer, a Danish research team reports.
"The difference in life expectancy between sexes is at least partially explained by a superior female resistance to a number of diseases and men's tendency to engage in more high-risk behavior," Dr. Tom Skyhoj Olsen told Reuters Health. "So we asked ourselves the question: If women are better than men in avoiding disease, why shouldn't they also be better in handling disease?"
Most studies have failed to identify gender differences in stroke survival, Dr. Olsen, at Hvidovre University Hospital, and his colleagues note in the their paper, published online on December 13 by the journal Neuroepidemiology.
To further explore this topic while including variables for stroke severity, the investigators analyzed data for the nearly 40,000 patients registered in the Danish National Indicator Project between 2001 and 2007 and followed for up to 5 years.
In unadjusted analyses, men had the "survival advantage," the report indicates. However, when including the 22,222 individuals with complete data and adjusting for stroke severity and subtype, age, and cardiovascular risk factors, women had an overall lower risk of all-cause death compared to men (hazard ratio 0.832, p < 0.001).
"Except for the period between 30 and 60 days after stroke, mortality is markedly lower in female stroke survivors, and the gap between men and women continues to increase," the authors report.
Dr. Olsen's group notes that, because females tend to be older at the time of stroke and have more severe strokes, "case-fatality rates of men and women are not directly comparable."
They advise, therefore, that "survival after stroke should be handled separately in men and women, as the longer survival period of women does not necessarily reflect a less severe stroke or a more favorable effect of a given treatment."
As to possible biological mechanisms underlying these gender differences, Dr. Olsen noted that "the mean age of women in the study was 75 years. So we conclude that female sex hormones probably play a minor role for the observed female survival advantage - we believe the survival advantage is genetically bound to women."
"We are now in the very first beginning of an era where we realize the need of individualization in treatment of disease," he added. "Our research further gives support to work and research in that direction."
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