Women who had suffered a stroke may not be tested for heart and neck artery conditions much frequently as it should be done.
According to a new University of Michigan study while those tests appear to be under-used in all stroke patients no matter what their gender, the difference in testing between men and women may help explain why women tend to have a worse long-term outcome from stroke, including a higher death rate. The study is published in the recent issue of the journal Neurology.
The findings, from a study of 1,234 stroke patients treated in Texas community hospitals, show that there's still a long way to go in diagnostic evaluation of all patients who suffer ischemic strokes. About 88 percent of all strokes are ischemic, which means they're caused by blood clots traveling to the brain or by blockages in the carotid arteries in the neck that supply blood to the brain.
One in every seven people who has a stroke will have another one within a year. The study looked at the use of tests that can cut that risk, by assessing the potential for blood clots to form in the heart, and the health of the carotid arteries. The results of such tests can guide doctors to prescribe preventive treatment and help patients understand what they must do to prevent a second stroke.
The new paper is based on detailed analysis of records from a random sample of 381 patients, 220 of them female and half of them Mexican-American.
It found that women were 36 percent less likely than men to receive an echocardiogram of their heart, a test similar to pregnancy ultrasound that creates a movie of the heart and can looks for clot-producing conditions and other problems. Women were also 43 percent less likely to have exams of their carotid arteries, which can become narrowed by cholesterol plaque that blocks blood flow and spawns clots.
The gender difference in testing rates was still present in the study even after the researchers took into account factors such as age, ethnicity, insurance status, stroke risk factors, stroke severity, blood pressure and atrial fibrillation, a heart rhythm condition that encourages the formation of clots in the heart.