After analyzing stroke treatment records, researchers at Rhode Island Hospital in collaboration with researchers from the University of Cincinnati learned that women and men have different reasons for being excluded from receiving the common clot-dissolving drug, recombinant tissue plasminogen activator (rtPA). Importantly, more women had very high blood pressures, which reduced their eligibility to be treated with the highly effective drug. The study was recently published in the American Heart Association's (AHA) journal, Stroke.
"Although men and women had similar overall eligibility rates for rtPA, women were more likely to have severe hypertension -- a potentially treatable condition but a reason they can be excluded from receiving tPA," said Tracy Madsen, M.D., an emergency department physician at Rhode Island Hospital. Madsen's main research focus is sex and gender differences in stroke, and she is the primary author of the AHA Stroke paper.
"Interestingly, although the women were more likely to have severe hypertension, this treatable condition was often untreated," Madsen added.
According to the National Stroke Association, stroke is the third leading cause of death for women. In comparison, stroke is the fifth leading cause of death for men. Each year, 55,000 more women have a stroke than men. In general women live longer than men and have more long-term negative consequences after stroke, so stroke will have a more negative impact on their lives.
In addition to the hypertension exclusion, researchers found that women were more likely to be excluded from rtPA treatment because of other factors, such as advanced age (80+) and very large strokes.
As part of a large population-based stroke study, the researchers studied the records of all adult ischemic stroke patients at 16 hospitals in southwest Ohio and northern Kentucky in 2005. Patient eligibility for rtPA treatment and individual exclusion criteria was determined using the 2013 AHA and European Cooperative Acute Stroke Study (ECASS) III guidelines.