Background and Aims: Sex-differences in risk of ischemic stroke has been reported worldwide. These risks remained post-stroke and causes of recurrent. Stratifying risk for recurrent, based on sex differences, by using a clinical valid tool provide a tailor for appropriate prevention. We examined whether stroke women and men had differences risk score and risk levels for developing recurrent. Methods: We identified risk for recurrent stroke by using the Essen Stroke Risk Score (ESRS) among 3,135 ischemic strokes admitted at a tertiary care hospital in Southern Thailand. Approximately 40% were women (n=1,260). The ESRS scoring system was calculation based on seven indexes including age, hypertension, diabetes, previous myocardial infarction (MI), peripheral arterial disease (PAD), other cardiovascular diseases (CVD) except MI and atrial fibrillation (AF), and previous stroke/TIA. Risk levels were identified as low (score 0-2), and high (score 3-9). Results: Thirty-seven percent of women, and 40% of men were at the high-risk level. Rates of high-risk for recurrent among women and men were not differences (OR 0.93, 95%CI 0.85-1.02). Although women were more likely had less score on total ESRS (p=0.000), they had higher score on three indexes included age (p=0.000), hypertension (p=0.000), and diabetes (p=0.000). In contrast, they had less score on smoking index (p=0.000). Scores on MI, other CVD, PAD, and previous stroke/TIA were not differences. Conclusions: Women had high-risk levels for recurrent stroke as similar to men. Women were older, had hypertension, and diabetes, but less smoker. We noted that a greater score on total ESRS in men was extremely attributed by smoking.
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