Key result
Female sex is linked to ~60% higher odds of physical inactivity and higher LDL post-stroke.
Why the study?
Achieving secondary prevention goals after stroke is essential to reduce recurrent risk, but sex-based differences in target attainment required examination.
Are there sex-based differences in secondary prevention target attainment after a first-ever ischemic stroke?
Cohort (n=1,987)
Are there sex-based differences in secondary prevention target attainment after a first-ever ischemic stroke?
Effect estimate: aOR 1.6 (95% CI 1.3 to 2.0)
Absolute Event Rate: 81% vs 72.3%
Significant sex-based differences exist in secondary prevention goal attainment after ischemic stroke, with females having higher rates of physical inactivity, BMI, and LDL, while males have higher rates of smoking and alcohol use.
Female sex was associated with poorer secondary prevention after IS; leaves open benefit of sex-tailored strategies pending RCTs.
Background and aims Achieving secondary prevention goals after stroke is essential, and substantial evidence supports their effectiveness in reducing recurrent risk. We examined sex-based differences in secondary prevention target attainment after a first-ever ischemic stroke(IS). Methods Retrospective cohort study using Chilean database from the primary healthcare cardiovascular program of the Talcahuano Health Service during 2016-2024. Patients aged ≥15years with first-ever IS (ICD-10:I63) were included. Sex-differences were assessed using multivariable models adjusted for age and socioeconomic status (SES). Adjusted odds ratios (aORs) and adjusted mean differences (aMeanD) were reported with 95% confidence intervals (95% CI) (Stata v.19.0). Results Among 86,050 program participants, 1,987 IS patients were identified, 51.2% were females, mean age 69.2 years, and 73.9% had low SES. Similar outcomes by sex were observed in the mean of systolic blood pressure (females:135.5 mmHg vs males:136.3mmHg), fasting blood glucose (126.6mg/dl vs 125.6mg/dl), and HbA1c (7.7%vs7.7%). Females were more likely than males to have physical inactivity (81.0%vs 72.3%; aOR:1.6 (95%CI:1.3 to 2.0)), higher mean body mass index (30.9kg/m2 vs 28.8kg/m2; aMeanD:2.1kg/m2 (1.7 to 2.6)), and higher mean LDL cholesterol (84.5mg/dL vs 78.6mg/dL; aMeanD:5.8mg/dL (2.3 to 9.4)). In contrast, males were more likely to have an alcohol use disorder (2.3%vs10.0%; aOR:0.2 (0.1 to 0.3)), and current smoking (13.2%vs 20.7%; aOR:0.6 (0.4 to 0.7)). Conclusions Secondary prevention goal attainment remains suboptimal, and sex-related differences were identified, underscoring the need for sex-specific prevention strategies. Conflict of interest The authors declare that they have nothing to disclose related to this abstract. Figure 1 - belongs to Conclusions
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Núñez et al. (2026) conducted a cohort in first-ever ischemic stroke (n=1,987). Female sex vs. Male sex was evaluated on Physical inactivity (aOR 1.6, 95% CI 1.3 to 2.0). Female sex was associated with higher rates of physical inactivity (81.0% vs 72.3%; aOR 1.6, 95% CI 1.3-2.0) and higher LDL cholesterol compared to males following a first-ever ischemic stroke.
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