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Ischemic stroke more likely in women with severe hypertension

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Women with increasing levels of hypertension had an increased risk for ischemic stroke compared with men, according to an abstract presented at the International Stroke Conference.

“Our findings suggest that women may have a greater risk of stroke than men from increasing severity of hypertension and suggest the need for further research,” Tracy E. Madsen, MD, ScM, assistant professor of emergency medicine in the division of sex and gender in emergency medicine at Brown University Alpert Medical School, told Cardiology Today. “We need to confirm if this pattern holds true when using the most recently published set of guidelines for hypertension.”

Researchers analyzed data from 26,461 participants (55% women; 40% black) from the REGARDS study who were free from stroke at baseline.

In-home assessments were conducted at baseline to collect information on race, age, sex, number of antihypertensive medications and systolic BP. Telephone surveillance was then performed every 6 months for ischemic stroke incident events. Medical records were reviewed for suspected events.

During a median follow-up of 8.7 years, 1,084 ischemic strokes occurred.

Across increasing levels of hypertension severity, women were at an increased risk for ischemic stroke (HR = 1.32; 95% CI, 1.19-1.46) compared with men (HR = 1.16; 95% CI, 1.04-1.29) after adjusting for covariates (P for sex-systolic BP interaction = .087).

The number of antihypertensive medications increased ischemic stroke risk similarly in both sexes (P = .6). The risk for ischemic stroke was 1.31 times higher in participants taking one medication (95% CI, 1.1-1.55), 1.48 times higher in those taking two medications (95% CI, 1.25-1.75) and 1.88 times higher in participants taking three or more medications (95% CI, 1.57-2.25) compared with participants on no medications.

“Further investigations on the biological mechanisms for sex differences in [hypertension] and stroke and the potential need for sex-specific clinical guidelines are warranted,” Madsen and colleagues wrote. – by Darlene Dobkowski

Reference:

Madsen TE, et al. Abstract 184. Presented at: International Stroke Conference; Jan. 23-26, 2018; Los Angeles.

Disclosure: Madsen reports no relevant financial disclosures.