Key result
Hypertension and T2D linked to ~141% higher relative stroke risk in men versus women.
Why the study?
The study was conducted to assess sex differences in the association between blood pressure categories and glucose intolerance status with overall and ischemic stroke among Iranian adults.
Do hypertension and type 2 diabetes confer a different risk of incident stroke in men compared to women?
Cohort (n=5,349)
Do hypertension and type 2 diabetes confer a different risk of incident stroke in men compared to women?
In an Iranian cohort, hypertension and type 2 diabetes conferred a significantly higher relative risk of overall and ischemic stroke in men compared to women.
Should not yet change risk stratification; leaves open whether sex modifies effects of hypertension and diabetes on stroke.
BACKGROUND: We assessed the sex differences in the association between blood pressure categories and glucose intolerance status with overall and ischemic stroke among Iranian adults. METHODS: This prospective study was conducted on 5349 individuals (2446 men) aged ≥ 40 years. Cox models were used to estimate adjusted hazard ratios (HRs) and men-to-women ratios of HRs (RHRs) of overall and ischemic stroke for systolic (SBP) and diastolic (DBP) blood pressure, pre-hypertension, hypertension, fasting plasma glucose (FPG), pre-diabetes and type 2 diabetes (T2D). RESULTS: Each 0.55 mmol/L increase in FPG was associated with a higher HR of overall stroke in men than women [RHRs 1.05 (1.01-1.09)]. The associations between each 10 mmHg increase in DBP and stroke events were stronger in men than women, with RHRs of 1.20 (1.00-1.45) and 1.29 (1.04-1.60) for overall and ischemic stroke, respectively. Hypertension was associated with a higher HR of overall [RHRs: 2.41 (1.21-4.8)] and ischemic stroke [2.37 (1.12-5.01)] in men than women. We also found that T2D was associated with higher risks of overall and ischemic stroke in men than women: the RHRs were 2.16 (1.24-3.75) and 1.93 (1.05-3.55) for overall and ischemic stroke, respectively. CONCLUSION: Hypertension and T2D induced higher risk of overall and ischemic stroke in men than women among Iranian population.
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Ramezankhani et al. (2022) conducted a cohort in Stroke (n=5,349). Hypertension vs. Women (sex difference) was evaluated on Overall stroke associated with hypertension (men-to-women ratio of HRs) (RHR 2.41, 95% CI 1.21-4.8). Hypertension and type 2 diabetes were associated with a significantly higher risk of overall stroke in men compared to women, with men-to-women ratios of hazard ratios of 2.41 and 2.16, respectively.
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