Women often delay seeking care for stroke symptoms

Women take longer than men to get to the hospital when they experience stroke symptoms and they have worse neurological deficits, investigators reported here at the International Stroke Conference 2009, sponsored by the American Stroke Association.

"Once they arrived at the hospital, women received the same treatment - the same speed of evaluation, and the same rate of treatment - but women took longer to get to the hospital," said Dr. Louise D. McCullough of the University of Connecticut Health Center in Farmington.

"Historically, male gender has been considered a risk factor for stroke," she told meeting attendees. "However, in 2004, the majority of deaths (due) to stroke were in females, at 60.9 percent compared with 39.1 percent in men."

McCullough's team took a look back at data from 215 men and 230 women aged 45 years and older who were seen at the Hartford Hospital Stroke Center within 6 hours of the onset of stroke symptoms. Classic stroke symptoms include weakness in one part of the body, particularly an arm or leg; difficulty speaking, facial droop, severe headache, mental confusion and dizziness.

According to McCullough and colleagues, on arrival at the hospital, women had more severe stroke symptoms than men, and worse function.

"Women don't seem to have the same sense of urgency as men," McCullough told Reuters Health. "They tend to minimize the importance of their symptoms."

Women were significantly older than men, at 76.1 years compared with 71.8 years for men, and lived alone more often than men.

"Because they live alone more often, they don't have someone available who can recognize the symptoms and call 9-1-1 for them," McCullough commented. "Also, patients may have confusion or aphasia (difficulty speaking), which would interfere with their seeking help. But mostly, we found that women just didn't think their symptoms were 'urgent'."

"There is a very important pubic health message here," McCullough said. "These are difficult issues that are hard to address. I find my patients don't feel comfortable discussing their health and they minimize the importance of their own health...and their perception of risk is different than men's. Women don't perceive themselves as at high risk."

When stroke is suspected, women should "know to call 9-1-1 and get to the hospital, rather than call their doctor and wait for a response," McCullough added. "It sounds simple, but they should know to use the word 'stroke' when they call 9-1-1. It triggers the emergency response system."

By Martha Kerr
SAN DIEGO (Reuters Health)