Abstract
Sex differences are present in many diseases, especially those that involve the neurological and cardiovascular systems. Unfortunately, these differences have historically been neglected in preclinical research, as many studies only include one sex (typically males). Ignoring the biological variable of sex in these diseases leads to a disparity in care and a lack of understanding on how sex may influence risk factors, presentation of symptoms, recovery, and response to treatment. This chapter outlines what is known regarding sex differences in ischemic stroke, detailing both clinical and pre-clinical evidence. Firstly, there are sex differences in prevalence of ischemic stroke risk factors and the degree to which these conditions increase risk for stroke. Moreover, conditions such as pregnancy and menopause are female-specific risk factors that have largely gone understudied. Presentation of symptoms and response to treatment differ between men and women, and there are also sex disparities in acute and chronic outcomes between the sexes. Gonadal hormone expression is often touted as the cause for sex differences in ischemic stroke, and while this does play a significant role, there is emerging evidence for the contribution of sex chromosomes to stroke outcomes. The objective of this chapter is to make a case for more sex- and gender-based medicine and to underscore the need for considering sex as a biological variable in ischemic stroke research.
Published Version
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