Men and women are different, even when it comes to strokes

New evidence often comes to light nowadays, highlighting the need for research and clinical care to be handled differently for men and women. As with myocardial infarction and so many other health conditions, women suffer a stroke differently from men. Women need to be more aware of these marked differences because, not only do strokes have a very high capacity to change a patient's life from one moment to the next, but also because they have much more serious consequences for women.

This potentially fatal situation is especially relevant for women as one of the distinguishing features of their suffering a stroke is that it is more likely to occur for them at a later age. In general, strokes occur in women in the last stage of a long life, from the age of 75 upwards. It is not, therefore, just a matter of the risk involved in dealing with the trauma brought on by something as serious as a stroke, which is by definition more serious for women in any case, but of the higher chances of it occurring at a time when they are alone.

This is the main point made by neurologist Covadonga Fernández Maiztegi, who spoke on this topic earlier this month to a group of women in the town of Getxo in Vizcaya. In other words, women tend to suffer a stroke when they are very old, already in a weakened state of health and often without people nearby to act quickly to help them.

A recent study by charitable body Fundación La Caixa estimated that 70% of elderly people living alone are female. At that age it is normal for the children to have left home and there is a very strong possibility of their being widowed. Life expectancy for men in Spain is, on average, almost six years shorter than for women (79.5 years compared to 82.2). "The challenge is enormous with a disease like this one, in which time is life, every minute counts," emphasises this specialist from the Basque Country who heads up the neurology department for outpatients at Cruces Hospital.

When faced with a possible stroke, it is important not to waste a single minute. The less the clock ticks by before help arrives, the greater the chances of survival or of suffering less brain damage. New medical treatments and the deployment of urgent intervention programmes like the stroke code, a fast-action response plan, have led to significant improvements in clinical outcomes. Even with all these measures, every second still counts.

The time it takes to respond to, diagnose and treat a stroke is estimated at four and a half hours. The countdown starts from the moment the stroke occurs. As the specialist points out, the widespread, popular view is that if someone, a relative or a neighbour, takes the suspected stroke victim to the hospital, this will save time. This is not true. This belief is a major mistake.

It is possible that the ambulance needs time to get to the place where the patient to be transported is located and that a private car would reach the hospital A&E much sooner. However, someone would then have to queue up at reception and announce that there is an emergency for which the staff are unprepared. If transported to hospital by ambulance, once the patient arrives, there will be a whole specialised team on hand to receive and attend immediately to the patient.

Another very common mistake made by women, especially older women, is to prioritise the needs of others over one's own. When faced with a stroke, it is not enough to say "I'm not well, but I'm going to finish what I'm doing and then call the ambulance." You are wasting valuable time.

Social services often offer people aged over 75 years living alone a telecare service, which is a definite help in the event of a stroke. It is a device worn around the patient's neck with an emergency push button connected to a telephone switchboard. The trained staff knows that if it rings, there is an emergency and someone is there on the line to help.

It is more than possible, according to Fernández Maiztegi, that in ten years' time, how strokes happen for women will be more similar to strokes in men. Today's typical patient corresponds to a female profile that is no longer in the population majority. Such elderly women belong to a time when most of them did not work outside the home, smoke or drink like men. Moreover, men also worked in jobs that have disappeared in today's environment.

Thus, it turns out that men and women aged 60 to 65 have been exposed to virtually the same risks to their health. This also means that younger men and women are even more evenly matched. Diseases, for better and for worse, evolve with societal changes.