Sex-Specific Incidence of Hemorrhagic Stroke in Japan: An Integrated Population-Based Study

In Japan’s Shiga Stroke and Heart Attack Registry (2011–2015), overall hemorrhagic stroke incidence is nearly identical between men and women (71.6 vs 72.2 per 100,000 person-years) despite opposite subtype patterns.

• Why it matters: Sex differences in intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) are often studied separately, leaving uncertainty about how they combine to shape total hemorrhagic stroke incidence by sex.
• What they did: The study integrated first-ever ICH and SAH events from 4,517 patients in a population-based registry covering ~1.4 million residents, calculating age-adjusted incidence rates by sex and subtype using direct standardization to the 2015 Japanese Census.
• The result: ICH incidence was higher in men (61.2 vs 49.8 per 100,000 person-years) while SAH incidence was more than twice as high in women (22.4 vs 10.4), offsetting each other so total incidence matched closely.

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