Gender features in cerebrovascular disorders in different age groups

Introduction. Numerous studies of ischaemic stroke pathogenesis allowed to develop the modern concept of the causes of ischaemic stroke. Risk factors are of primary importance in the development of cerebrovascular disorders (CVD).

Study aim – to examine the representation of risk factors for CVD and the causes of ischaemic stroke in the territory of the internal carotid artery, taking into account age and gender differences.

Materials and methods. We examined 331 (47.7%) men and 363 (52.3%) women aged 25–89 years with chronic CVD and ischaemic stroke in the territory of the internal carotid artery. Of the 279 patients with ischaemic stroke in the territory of the internal carotid artery, 57.7% were male and 42.3% were female. The majority of patients with ischaemic stroke were aged between 60 and 74 years, both among the men (72; 57.6%) and among the women (53; 42.4%).

Results. Men were more likely to have arterial hypertension (64.4% vs. 49.6%; p<0.001), a history of transient ischaemic attacks (16.6% vs. 8.6%; p=0.002) and ischaemic stroke (14.5% vs. 9.1%; p=0.033), coronary heart disease (post-infarction cardiosclerosis) (13.9% vs. 7.2%; p=0.004), and to smoke (42.3% vs. 20.2%; p<0.001) and to consume excess alcohol (14.8% vs. 2.5%; p<0.001) than women. Atherothrombotic stroke was more common in men than in women (38.1% versus 21.2%; p=0.003). Women were more likely than men to have a cardioembolic stroke (39.0% vs. 21.9%; p=0.002) and a stroke due to internal carotid artery dissection (6.8% vs. 1.3%; p=0.020). In the 60–74-year age group, men were more likely to have atherothrombotic stroke (49.3% vs. 22.6%; p=0.002), while women were more likely to have cardioembolic stroke (47.2% vs. 26.8%; p=0.019) or a lacunar infarct (17% vs. 4.2%; p=0.017).

Conclusion. Gender and age differences were found in the frequency of risk factors for CVD and in subtypes of ischaemic stroke. Men are more likely than women to have arterial hypertension, a history of transient ischemic attacks and stroke, coronary heart disease, and to smoke and to consume excess alcohol. Ischaemic stroke in the territory of the internal carotid artery occurs more often in older men and women. Among the ischaemic stroke subtypes in that age group, atherothrombotic stroke was more common in men, while cardioembolic and lacunar infarcts were more common in women.