In addition, the death rate after surgery was higher for women, 5.7 percent as opposed to 3.5 percent for men. And when investigators made statistical adjustments to control for risk factors like high blood pressure, diabetes and smoking, women were still at about 21 percent increased risk over men. While the gender difference is notable, heart operations, particularly coronary bypass surgery, have become relatively safe. Death rates for the surgery have not increased appreciably in the past 10 years, even though procedures are being done on patients who are older and sicker. It has long been known that women who have heart surgery tend to fare worse than men, but the role of stroke as a contributor to poor outcomes hadn't been determined.
Postoperative stroke is a devastating complication for both men and women.
Our challenge is to identify the causes of strokes and to devise aggressive strategies to prevent them. Davila-Romain and Hogue suggest that decreased levels of the hormone estrogen may contribute to the elevated risk. Most female heart patients are operated on 10 to 15 years after they go through menopause. Estrogen is thought to help protect women from heart disease before menopause and some research also indicates the brain chemical protects against damage to cells in the brain. Men have less estrogen in their bodies than women, but they do make some by converting part of the male hormone, androgen, into estrogen.