Older Women Fare Better, Live Longer than Men after First "Mini Stroke"

Elderly women who suffer a first “mini-stroke” are less likely than men of the same age to be readmitted to a hospital, according to a study led by the Yale School of Public Health. The paper appears in the online version of Stroke, the journal of the American Heart Association.

Transient ischemic attack (TIA) is known as a mini-stroke because it produces stroke-like symptoms but no lasting damage. TIA is often considered a harbinger of more serious health problems, including full-fledged strokes, coronary artery disease, and even death. Almost one in 10 TIA patients are readmitted to the hospital within a month after the initial event and half are readmitted within a year.

While additional research is needed to better understand the reasons for the gender-related difference in health outcomes, the findings could help to improve care and outcomes for both men and women, said Judith H. Lichtman, an associate professor in the division of Chronic Disease Epidemiology and the study’s lead author.

“Identifying opportunities to improve primary and secondary stroke prevention is increasingly important as our population ages and is at greater risk for stroke events. Identifying and treating TIA events represents an important step in reducing the burden of stroke in the elderly,” Lichtman said.

The study reviewed records on more than 122,000 patients, 65 and older, who were hospitalized with a TIA in 2002. Follow-up research showed fewer women were subsequently readmitted for stroke or coronary artery disease, and had lower mortality rates after an initial TIA than did their male counterparts.

Thirty days after a TIA, women were 30 percent less likely to have a stroke, 14 percent less likely to have heart-related problems and 26 percent less likely to die. Within a year, women were 15 percent less likely to have a stroke, 19 percent less likely to have a cardiac event and 22 percent less likely to die.

The data also indicated that men are subject to poorer prognosis after TIA, even after accounting for demographics, medical history and co-existing conditions. However, women have higher rates—about 6 percent—of recurring TIA after one year

The gender-based differences in outcome may be due to differences in the cause of TIA, Lichtman said. There also may be differences in care-seeking behavior, initial diagnostic evaluation and in the receipt of and/or compliance with secondary prevention measures.

Researchers from the School of Public Health at the University of Alabama at Birmingham, and the Duke Stroke Center were also part of the study team. The research was funded by a grant from the National Institute of Neurological Disorders and Stroke.