Addressing sex and gender differences in stroke risk and management: A scientific statement from the World Stroke Organization

Cheryl Carcel; Else Charlotte Sandset; Mariam Ali; Maria Ignacia Allende Echanez; Maria Giulia Mosconi; Ana Cláudia de Souza; Lachlan L Dalli; MUÑOZ VENTURELLI, PAULA ANDREA; Yuki Sakamoto; Ahmed Nasreldein; Amy YX Yu; Silke Walter; Natasha A Lannin; Avril Drummond; Valeria Caso; Suvarna Alladi; Cheryl D Bushnell; Mathew J Reeves; Seana Gall

doi:10.1177/17474930251393009

Addressing sex and gender differences in stroke risk and management: A scientific statement from the World Stroke Organization

Journal

International Journal of Stroke

ISSN

1747-4930

Date Issued

2025-10-23

Author(s)

Cheryl Carcel

Else Charlotte Sandset

Mariam Ali

Maria Ignacia Allende Echanez

Maria Giulia Mosconi

Ana Cláudia de Souza

Lachlan L Dalli

MUÑOZ VENTURELLI, PAULA ANDREA

Facultad de Medicina Clínica Alemana Universidad del Desarrollo

Yuki Sakamoto

Ahmed Nasreldein

Amy YX Yu

Silke Walter

Natasha A Lannin

Avril Drummond

Valeria Caso

Suvarna Alladi

Cheryl D Bushnell

Mathew J Reeves

Seana Gall

Type

journal-article

DOI

10.1177/17474930251393009

URL

https://hdl.handle.net/123456789/11656

Abstract

This World Stroke Organization Scientific Statement highlights how sex and gender differences shape stroke risk, treatment, care, and research. Estrogen confers a relative protection before menopause, with risk increasing thereafter. Beyond shared cardiovascular determinants (hypertension, atrial fibrillation, and diabetes), women face sex-specific risks—hypertensive disorders of pregnancy, menopause, and hormone therapy, with clear implications for stroke prevention and management. Despite comparable efficacy of acute and secondary stroke therapies in women and men, women are less likely to receive timely acute treatment and often experience delays in recognition and access. The statement recommends gender-responsive prevention and care pathways; systematic consideration of pregnancy-related and menopausal factors; and public and professional education to improve stroke symptom recognition and purposeful inclusion of women across the research continuum. By integrating evidence from epidemiology, acute care, and secondary prevention, this statement provides clear and timely guidance for reducing inequities and shaping future research and policy to achieve equitable stroke care globally.