Stroke is one of the most feared diseases in modern medicine. It strikes suddenly, often without warning, and leaves long-lasting impacts. The World Health Organization (WHO) records that stroke is the leading cause of long-term disability, while in 2021, one in six deaths from cardiovascular disease was due to stroke. Seeing the magnitude of this threat, research on stroke risk factors and symptoms continues to be intensified—not only in general, but also in more detail, including the differences that may occur between men and women.

 

A study conducted at Haji Adam Malik Hospital, Medan, attempted to uncover this question. The scientific article titled Gender differences in risk factors and clinical profiles of ischemic stroke patients: A cross-sectional study at Adam Malik Hospital, Medan was published in 2025 in the Journal of Medicinal and Pharmaceutical Chemistry Research. This study was written by Cut Aria Arina and Yunika Khairina, both from the Department of Neurology, Faculty of Medicine, Universitas Sumatera Utara.

 

They highlighted ischemic stroke—the most common type of stroke, in which blood flow to the brain is blocked by a clot. Using a cross-sectional study design, they analyzed data from 227 patients who underwent treatment throughout 2022. Of these, 117 patients were men and 110 women. The aim was simple yet important: to identify differences in risk factors and clinical profiles between male and female patients so that stroke management could be more precisely targeted.

 

The results provided an interesting picture. The average age of male patients with stroke was 57.7 years, while women were slightly older, at 62.2 years. This means men tend to experience strokes at a younger age, while women are more often affected when entering old age. This is consistent with global patterns showing that men have a higher risk at productive ages, but after menopause, women’s risk increases and can surpass that of men.

 

When it comes to risk factors, this study highlighted some that were very different between the two groups. In men, the most significant factors were smoking, hypertension, and coronary artery disease. Smoking, for example, is still strongly associated with adult men, especially those aged 18–44 years. Cigarette smoke damages blood vessels and accelerates blockage, thereby increasing stroke risk. Hypertension and coronary heart disease further reinforce this threat.

 

On the other hand, in women, the most prominent factor was obesity. Excess body weight has been proven to increase the risk of atherosclerosis or narrowing of blood vessels throughout the body, including the brain. In this study, the prevalence of obesity among female patients was much higher and significantly associated with stroke occurrence. “This finding is important because it shows that risk patterns are not identical. Stroke patient management must consider the dominant factors in each gender,” explained Cut Aria Arina when interviewed about this research.

 

From the symptom perspective, this study also found something interesting. In general, classic ischemic stroke symptoms such as weakness on one side of the body (hemiparesis), slurred speech (dysarthria), or language impairment (aphasia) appeared in both men and women without significant differences. However, there were two symptoms more commonly found in women: loss of consciousness and headache. This presents its own challenge because these symptoms can be considered non-specific, so stroke diagnosis in women risks being delayed.

 

The fact that women more often show non-focal or atypical symptoms has long been a concern in medicine. Symptoms such as dizziness, confusion, chest pain, or palpitations often mislead, even for medical personnel. As a result, stroke in women risks going undetected early. The study by Arina and Khairina strengthens the evidence that awareness of these differences is crucial in clinical practice.

 

Why can these differences occur? Several theories have been proposed. One relates to the role of hormones. Estrogen in young women is known to have a protective effect on blood vessels. It helps maintain the elasticity of vessel walls and facilitates blood flow. However, after menopause, estrogen levels decrease drastically, eliminating that protection. Meanwhile, in men, testosterone actually has the opposite effect, increasing the risk of cardiovascular problems from a younger age.

 

In addition to hormones, lifestyle also contributes. Smoking habits are more common among men, while obesity is more frequently found in women, especially after middle age. Diet, physical activity, and social factors also shape this risk profile. As explained by Cut Aria Arina, “The data we obtained confirm that stroke prevention approaches cannot be one-size-fits-all. Women and men have different vulnerabilities that must be taken into account.”

 

This study also found that diabetes mellitus, atrial fibrillation, dyslipidemia, and structural heart disease did not show significant differences between men and women. This means these factors apply equally strongly to both genders. This finding differs from several international studies that showed atrial fibrillation was more often a risk factor in women. This difference may have occurred because of the relatively limited sample size and the heterogeneity of the patient population in Medan.

 

When compared with global literature, the results of this study are in line with large studies such as INTERSTROKE, which noted that nearly 90 percent of stroke risk can be explained by modifiable factors, such as hypertension, smoking, obesity, diet, physical activity, diabetes, alcohol consumption, and stress. However, the details of gender differences add a new layer of understanding that is crucial for clinicians.

 

From the methodological side, this study used a cross-sectional design based on patient medical records at Adam Malik Hospital throughout 2022. A total of 227 patients were selected using consecutive sampling, which means that every patient with an ischemic stroke diagnosis and complete data was included in the analysis. Although simple, this design allowed the researchers to describe real patterns in the field quite well.

 

Nevertheless, Arina acknowledged the limitations of their study. Because the research was conducted at only one hospital, the results may not necessarily represent a broader population. In addition, there were some female-specific risk factors that were not analyzed, such as a history of pregnancy complications, use of estrogen hormone therapy, or the duration of lifetime estrogen exposure from menarche to menopause. These factors have been shown in many international studies to be closely related to stroke risk in women.

 

Despite these limitations, the study’s findings remain relevant to clinical practice. Doctors can be more alert that younger male patients with a history of smoking or hypertension are at high risk. Meanwhile, in women, extra attention needs to be given to obesity and non-focal symptoms that are often overlooked. If awareness increases, diagnosis can be established earlier, and treatment can be carried out more promptly.

 

In Indonesia, stroke is the leading cause of disability and one of the top causes of death. Data from the Basic Health Research survey shows its prevalence continues to increase along with the aging population and lifestyle changes. Therefore, local research such as that conducted by Arina and Khairina is very important. With data specific to patients in Medan, the results of this study provide a picture closer to field realities.

 

Interestingly, this study also reminds us that health issues cannot be separated from gender aspects. Biological, hormonal, and social differences shape distinct disease experiences. According to Arina, “We hope the results of this study can pave the way for more targeted prevention programs, both for men and women.” This statement reflects the researchers’ spirit not only to collect data but also to use it for real improvements in healthcare services.

 

Looking ahead, further research with a broader scope is certainly needed. Multi-center analyses with larger patient numbers will help strengthen the findings. In addition, exploring female-specific risk factors, such as reproductive history and hormone use, will enrich understanding. However, as an initial step, this study has already made an important contribution.

 

From the explanation above, it is clear that gender differences in stroke are not merely statistical notes. They are real, influencing age of onset, risk factors, and clinical symptoms. This knowledge should make medical practitioners more careful in diagnosing and preventing. And for the general public, this awareness can serve as a reminder that maintaining health is not enough with generic prescriptions but must consider individual conditions.

 

The research by Cut Aria Arina and Yunika Khairina proves that local studies can provide valuable insights that are globally relevant. Amid the rising incidence of stroke, their contribution is an important stepping stone toward healthcare services that are more gender-sensitive and more effective.