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Post-stroke tests not used often enough, especially in women

ANN ARBOR, Mich. -- Women who survive a stroke are less likely than men to get crucial tests of their heart and neck arteries that can help improve their treatment and reduce their risk of a second stroke, a new University of Michigan study finds.

And 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 Sept. 27 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.

"Diagnostic evaluations that should be done on every ischemic stroke patient still aren't being performed on a third to a half of patients, and they're less likely to be performed on women," says senior author Lewis Morgenstern, M.D., director of the Stroke Program in the U-M Cardiovascular Center. "Intervention is needed to increase access to quality stroke care for all patients, but especially women."

Morgenstern, a stroke neurologist who leads the Brain Attack Surveillance in Corpus Christi, or BASIC, study from which the new data were gathered, is a professor in the Department
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
26-Sep-2005


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