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Objective: This study was undertaken to delineate 21‐year sex‐specific trends in recurrence and postrecurrence mortality. Methods: Between 2000 and 2020, first‐ever ischemic stroke (IS) patients, ascertained from the population‐based BASIC (Brain Attack Surveillance in Corpus Christi) project in South Texas, were followed for recurrent stroke and all‐cause mortality until December 31, 2020. Multivariable regression models with an interaction between calendar year and sex were used to estimate sex‐specific trends and sex differences in recurrence and postrecurrence mortality. Results: Of the 6,057 IS patients (median age = 69 years, 49.8% women), 654 (10.8%) had a recurrence and 399 (47.7%) had postrecurrence mortality during 5 years of follow‐up. In 2000, women had 2.5% higher albeit non‐statistically significant 5‐year risk of recurrence than men in absolute scale. With the trend declining in women by 7.6% (95% confidence interval [CI] = −10.8 to −4.5%) and in men by 3.6% (95% CI = −6.5% to −0.7%), the risk at the end of the study period was 1.5% (95% CI = −0.3% to 3.6%) lower among women than men. For postrecurrence mortality, the risk was 10.2% lower among women in 2000, but the sex difference was 3.3% by the end of the period, which was due to a larger overall increase in the risk among women than men over the entire time period. Interpretation: The declines in recurrent stroke suggest successful secondary stroke prevention, especially in women. However, the continued high postrecurrence mortality among both sexes at the end of study period emphasizes the need for ongoing interventions to improve prognosis in those who have had recurrent cerebrovascular events. ANN NEUROL 2024;96:332–342 [ABSTRACT FROM AUTHOR]

Objective: To investigate stroke outcomes at 3, 6, and 12 months post‐stroke overall and by ethnicity in a population‐based, longitudinal study. Methods: First‐ever ischemic strokes (2014–2019, n = 1,332) among Mexican American persons (n = 807) and non‐Hispanic white persons (n = 525) were identified from the Brain Attack Surveillance in Corpus Christi Project. Data were collected from patient or proxy interviews (baseline, 3, 6, and 12 months post‐stroke) and medical records, including functional (activities of daily living/instrumental activities of daily living score), neurological (National Institutes of Health Stroke Scale), cognitive (Modified Mini‐Mental State Examination), and quality of life (QOL) outcomes (12‐domain Stroke‐specific Quality of Life scale). Outcome trajectories were analyzed using multivariable adjusted linear models, with generalized estimating equations to account for within‐subject correlations; interactions between ethnicity and time were included to investigate ethnic differences in outcomes. Results: The median age was 67 years (interquartile range 58,78), 48.5% were women, and 60.6% were Mexican American persons. For all outcomes, significant improvement was seen between 3 and 6 months (p < 0.05 for all), with stability between 6 and 12 months. Mexican American persons had significantly worse outcomes compared with non‐Hispanic white persons at all time points (3, 6, and 12 months), with the exception of the National Institutes of Health Stroke Scale, which did not differ by ethnicity at 6 and 12 months, and the average change in outcomes did not vary significantly by ethnicity. Interpretation: Outcomes were at their worst at 3 months post‐stroke, and ethnic disparities were already present, suggesting the need for early assessment and strategies to improve outcomes and possibly reduce disparities. ANN NEUROL 2023;93:348–356 [ABSTRACT FROM AUTHOR]