Key result
In hypertensive women, a common carotid artery diameter >8.10 mm was associated with a 2.49-fold greater risk of stroke compared to ≤6.80 mm (95% CI 1.36-4.56).
Why the study?
Sex is an established risk factor for stroke, but sex-related disparities in carotid artery diameter and stroke in a hypertensive population remained to be assessed.
Does common carotid artery diameter predict stroke risk differently by sex in a hypertensive population?
Cross-Sectional (n=3,245)
Does common carotid artery diameter predict stroke risk differently by sex in a hypertensive population?
Relative Risk: 2.49 (95% CI 1.36–4.56)
Common carotid artery diameter is positively associated with stroke prevalence in hypertensive women, but not men, suggesting a sex-specific value for stroke risk stratification.
May support sex-specific carotid diameter thresholds for stroke risk stratification in hypertension; leaves open prospective validation.
BACKGROUND: The importance of sex as a risk factor for stroke has been established. This study aimed to assess sex-related disparities in carotid artery diameter and stroke in a hypertensive population. METHODS: The cross-sectional survey was conducted in rural areas of northeast China. A multistage cluster sampling method was employed to select a representative population. The study comprised 3,245 individuals with hypertension. The common carotid artery (CCA) interadventitial diameter was measured by ultrasound. A linear model of restricted cubic spline function was used to characterize the concentration-response (C-R) relationship between CCA diameter and stroke. RESULTS: 7.6%). When the women's CCA diameters were divided into quartiles, the top quartile (>8.10 mm) had a 2.49 (95% CI: 1.36-4.56) times greater risk of stroke compared to the bottom quartile (≤6.80 mm) after adjustment was made for other variables. The C-R relationship further confirmed a positive association between CCA diameter and stroke prevalence in women. Moreover, a category-free net reclassification index (0.325; 95% CI: 0.173-0.476; P<0.001) and an integrated discrimination index (0.008; 95% CI: 0.004-0.012, P<0.001) showed improvement in predicting the probability of stroke from CCA diameter. However, no significant relationship between CCA diameter and prevalence of stroke was found in men. CONCLUSIONS: The risk of stroke increased proportionally with the enlargement of the CCA diameter in women, supporting the sex-specific value of CCA diameter in optimizing the risk stratification of stroke.
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Xue et al. (2021) conducted a cross-sectional in hypertension (n=3,245). Common carotid artery diameter >8.10 mm vs. Common carotid artery diameter ≤6.80 mm was evaluated on stroke (RR 2.49, 95% CI 1.36-4.56). In hypertensive women, a common carotid artery diameter >8.10 mm was associated with a 2.49-fold greater risk of stroke compared to ≤6.80 mm (95% CI 1.36-4.56).
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