Stroke incidence remains higher in men, despite strong risk
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An analysis of more than 470,000 patients from the UK Biobank cohort study demonstrated that, while several risk factors strongly correlated with stroke risk in women compared with men, the rate of stroke remained higher among men.

This study aimed to determine whether there are sex differences in the association between risk factors and incident stroke, including stroke subtypes.

Four hundred seventy-one thousand nine hundred seventy-one (56% women) UK Biobank participants individuals without a history of cardiovascular disease were included. During 9 years of follow-up, 4,662 (44% women) cases of stroke were recorded. Cox models yielded adjusted hazard ratios (HRs), and women-to-men ratios of HRs (RHR), for stroke associated with 7 risk factors.

-- The incidence rate per 10,000 person years was 8.66 in women and 13.96 in men for any stroke; 6.06 in women and 11.35 in men for ischaemic stroke, and 1.56 in women and 2.23 in men for haemorrhagic stroke.

-- The association between increases in blood pressure, body anthropometry, and lipids, diabetes, and atrial fibrillation and any stroke was similar between men and women.

-- Hypertension, smoking, and a low socioeconomic status, respectively, were associated with a greater HR of any stroke in women than men; the RHRs were 1.36, 1.18, and 1.17.

-- Diabetes was associated with a higher HR of ischaemic stroke in women than men.

-- Atrial fibrillation was associated with a higher HR of haemorrhagic stroke in women than men.

Several risk factors are more strongly associated with the risk of any stroke or stroke subtypes in women compared with men. Despite this, the incidence of stroke remains higher among men than women, the authors concluded.

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