Stroke Disparities

Morgenstern, Lewis B.; Kissela, Brett M.

doi:10.1161/strokeaha.115.009533

Cited by 29 publications

(11 citation statements)

References 42 publications

(36 reference statements)

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“…Although this study's findings could not establish a causal relationship between breastfeeding and risk of stroke, health disparities surrounding stroke1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 and breastfeeding rates52, 53, 54 persist. Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4.…”

Section: Discussioncontrasting

confidence: 62%

“…Stroke costs the nation $34 billion annually including the cost of healthcare services, medications, and lost productivity 1. Approximately 55 000 more US women than men suffer from a stroke annually 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Compared with elderly men, elderly female stroke survivors are also at increased risk for moderate to severe disability, poorer quality of life, and institutionalization 16, 17…”

Section: Introductionmentioning

confidence: 99%

“…Stroke is higher among Hispanics and non‐Hispanic blacks compared with non‐Hispanic whites 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18. Hispanic and non‐Hispanic black women are at higher risk of stroke, partially due to increased rates of hypertension, obesity, diabetes mellitus, and physical inactivity,1, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 which are a few stroke risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Jacobson

Hade

Collins

et al. 2018

JAHA

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BackgroundStroke is the third leading cause of death among US Hispanic and non‐Hispanic black women aged 65 and older. One factor that may protect against stroke is breastfeeding. Few studies have assessed the association between breastfeeding and stroke and whether this association differs by race and ethnicity.Methods and ResultsData were taken from the Women's Health Initiative Observational Study with follow‐up through 2010; adjusted hazard ratios for stroke subsequent to childbirth were estimated with Cox regression models accounting for left and right censoring, overall and stratified by race/ethnicity. Of the 80 191 parous women in the Women's Health Initiative Observational Study, 2699 (3.4%) had experienced a stroke within a follow‐up period of 12.6 years. The average age was 63.7 years at baseline. Fifty‐eight percent (n=46 699) reported ever breastfeeding; 83% were non‐Hispanic white, 8% were non‐Hispanic black, 4% were Hispanic, and 5% were of other race/ethnicity. After adjustment for nonmodifiable potential confounders, compared with women who had never breastfed, women who reported ever breastfeeding had a 23% lower risk of stroke (adjusted hazard ratio=0.77; 95% confidence interval 0.70‐0.83). This association was strongest for non‐Hispanic black women (adjusted hazard ratio=0.52; 95% confidence interval 0.37‐0.71). Further, breastfeeding for a relatively short duration (1‐6 months) was associated with a 19% lower risk of stroke (adjusted hazard ratios=0.81; 95% confidence interval 0.74‐0.89). This association appeared stronger with longer breastfeeding duration and among non‐Hispanic white and non‐Hispanic black women (test for trend P<0.01).ConclusionsStudy results show an association and dose‐response relationship between breastfeeding and lower risk of stroke among postmenopausal women after adjustment for multiple stroke risk factors and lifestyle variables. Further investigation is warranted.

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Section: Discussioncontrasting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Jacobson

Hade

Collins

et al. 2018

JAHA

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“… Socio economic transition: It has been seen paradoxically that in certain regions, economic prosperity brought about a higher risk of stroke. [ 19 ] This is most probably that when money enters a previously impoverished area, it leads to irresponsible, and unhealthy behavior leading to risk of stroke. Therefore counseling for responsible use of wealth for themselves and their children is necessary to prevent the establishment of such risk factors.…”

Section: Primordial Preventionmentioning

confidence: 99%

Primordial prevention

Hussain¹

2021

Journal of Family Medicine and Primary Care

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Stroke, and neurodegenerative diseases represents, a major and rapidly growing burden of mortality and morbidity. The risk factors for stroke starts very early in life. Similarly, the changes of neurodegenerative diseases starts decades earlier than the clinical manifestations. Primordial prevention is necessary to prevent the establishment of risk factors to keep the population disease free. This will help to not only increase the life span, but also to prolong the health span.

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“…National guidelines emphasize rapid stroke identification and intervention in reducing stroke-related morbidity and mortality [1][2][3]. Women are known to experience delays in evaluation [4][5][6][7][8][9], receive fewer interventions such as thrombolytics [10][11][12][13], and have more functional impairment after an acute stroke [11,12,14,15], even when accounting for a number of confounding factors.…”

Section: Introductionmentioning

confidence: 99%

Gender differences in time from arrival to stroke team activation in patients presenting with acute stroke symptoms

2021

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Background and Purpose: Women are more likely to experience delays in evaluation and treatment for acute stroke. As national guidelines increasingly emphasize the importance of rapid stroke intervention, it is important to further investigate this gender disparity. We sought to evaluate whether door-to-stroke activation time varied by patient gender among patients for whom stroke team activation occurred in the emergency department (ED). Methods: This was a retrospective analysis of a prospectively collected registry of all patients for whom the stroke team was activated in the ED of an urban, academic, regional stroke center over 1 year. Our primary outcome was door to stroke activation time (DTA), with the primary predictor of interest being patient gender. We assessed for differences in DTA using multivariable Cox proportional hazards and logistic regression models. Results: There were 211 patient encounters included in the study, 117 women and 94 males. Median DTA was 8 minutes longer for women, and women were less likely to have DTA ≤ 15 minutes (odds ratio 0.26 [95% confidence interval 0.12 to 0.58]). Conclusion: A gender disparity existed in door to activation time for women presenting with suspected acute stroke, even when controlling for a variety of factors. These results provide evidence that gender may impact initial management of stroke patients.

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Stroke Disparities

Cited by 29 publications

References 42 publications

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Primordial prevention

Gender differences in time from arrival to stroke team activation in patients presenting with acute stroke symptoms

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