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WSC 2025 | Addressing disparities for women in stroke care and outcomes: the GENESIS initiative

Aleksandra Pikula, MD, University of Toronto, Toronto, Canada, discusses the unique gender-related disparities that women face in stroke prevention, diagnosis, and recovery. Dr Pikula then introduces the GENESIS initiative that aims to address these disparities. This interview took place at the 17th World Stroke Congress (WSC) in Barcelona, Spain.

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Transcript

In general, women experience distinct biological and gender risks across the lifespan, specifically around pregnancy, when we see adverse pregnancy outcomes such as hypertensive pregnancy disorders like preeclampsia, eclampsia, or gestational diabetes, as well as during midlife when we see menopause-related cardiometabolic and vascular changes. And those do have an effect on stroke risk in addition to traditional stroke risks, such as atrial fibrillation, hypertension, diabetes, that do have a much higher prevalence and perhaps a higher impact on stroke risk...

In general, women experience distinct biological and gender risks across the lifespan, specifically around pregnancy, when we see adverse pregnancy outcomes such as hypertensive pregnancy disorders like preeclampsia, eclampsia, or gestational diabetes, as well as during midlife when we see menopause-related cardiometabolic and vascular changes. And those do have an effect on stroke risk in addition to traditional stroke risks, such as atrial fibrillation, hypertension, diabetes, that do have a much higher prevalence and perhaps a higher impact on stroke risk. And if you add gender social roles to these caregivers, as well as social determinants of health, that also affect what we call health-seeking behavior, adherence to prevention. And then we talk about delays in assessment and inequities in access to care and outcomes. So really, when we talk about, you know, women and stroke, we see a lot of under-information. So women have low health literacy, they’re under-investigated, they’re under-diagnosed, and perhaps under-treated. And same in the recovery, there is a disproportionate burden of women where they have greater disability, higher likelihood of long-term care placements and gender barriers to intensive rehabilitation, and post-stroke trajectories are also impacted. So really GENESIS was established as the forefront of the World Stroke Organization committee that is focused on addressing these sex and gender-related disparities in stroke incidence, treatment, and outcome. And we hope, you know, with very inclusive geographic representation from all countries that we’ll be able to provide the networks, mentorship opportunities, advocate for policy changes, and promote inclusion in education, research, as well as clinical and leadership practices.

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