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Summary Stroke morbidity increases with age. That is the reason why it affects especially the middle aged and elderly. Because of longer life expectancy, by ca. 10 years, stroke is a major problem in women. 8% of males and 16% of females die due to stroke. Risk factors are basically the same in both sexes. The most important are hypertension, diabetes, dyslipidaemia, atrial fibrillation, coronary heart disease, previous stroke, smoking, alcohol abuse, obesity and lack of physical activity. Their impact, however, is different in males and females. Women with diabetes, atrial fibrillation, myocardial infarction, obese, drinking excessive amounts of alcohol and smoking are more likely to suffer of stroke than males with the same burden. Up to the age of 55, the course of stroke in women is less severe and the outcome more favorable. Women older than 55 have more severe strokes and higher stroke fatality and disability than men of the same age. It is possible that poor prognosis is related to a drop in blood estrogen concentration after menopause.
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