Gender-Related Differences in Modifiable Risk Factors and Ischemic Stroke Subtype in Young and Middle-Aged Patients – A Prospective Study

Abstract

Background: Male and female patients differ in their risk factors (RFs) and ischemic stroke (IS) subtype. A better understanding of the gender–related differences an important approach to successful prevention strategies for reducing the impact and burden of IS in young adults. Objective: To compare the gender–related differences in the prevalence of modifiable RFs and IS subtypes in young and middle-aged patients. Material and Methods: In the study were included 80 patients with acute IS, aged 18 – 59 years, admitted to the Neurology Clinic of UMHAT "Dr Georgi Stranski" Pleven. The following RFs were analyzed: arterial hypertension (AH), diabetes mellitus (DM), dyslipidemia, atrial fibrillation (AF), current smoking, number of cigarettes smoked per day, alcohol abuse, low physical activity, body overweight and chronic psychosocial stress. IS subtype was identified according to the Org 10172 Trial of Acute Stroke (TOAST). The statistical analysis was performed with the Statistical Package for Social Sciences, version 26.0 (SPSS). Results: Of all the 80 patients, 46 (57,5%) were males with a mean age 48,15±7,42 years, and 34 (42,5%) were females with a mean age 47,38±8,56. Male patients had higher rates of AH (80,4%), DM (47.8%), AF (4,3%), current smoking (73,9%), number of cigarettes smoked per day (60,9%), alcohol abuse (41,3%) and chronic psychosocial stress (52,2%), while the female ones showed higher rates of low physical activity (61,8%) and body overweight (38,2%). A statistical significance was found only for AH (p=0,004), DM (p=0,026), current smoking (p=0,007), number of cigarettes smoked per day (p=0,025) and alcohol abuse (p=0,031). The most common subtype of IS in males was large artery atherosclerosis (47,8%) and small vessel occlusion (28,3%). The female patients demonstrated a higher frequency of IS with other determined etiology (38,2%) and undetermined etiology (26,5%). Conclusion: Our data contribute to a better understanding of the gender–related differences of modifiable RFs and IS subtype in young and middle-aged patients with acute IS. The above findings definitely imply the necessity of developing additional specific therapeutic strategies for the effective control of modifiable RFs and lifestyle improvement in order to reduce the incidence of the most common subtypes of IS.