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Stroke risk differs by race, sex groups
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The disparity of stroke risk in men vs. women varied by race and age, researchers reported in JAMA Neurology.
In addition, stroke risk factors varied by sex in white adults but not in black adults, according to the researchers.
“This suggests that it may not be ‘one size fits all’ when it comes to stroke prevention,” Virginia Howard, PhD, professor of epidemiology in the School of Public Health at the University of Alabama at Birmingham, said in a press release. “For example, overall, black women may need better risk factor management and more aggressive risk factor management at younger ages than white women.”
Howard and colleagues analyzed 25,789 black and white participants (mean age, 64 years; 55% women; 40% black) from the REGARDS cohort study who were free from stroke at baseline.
During 222,120 person-years of follow-up, 939 strokes occurred (16.9% in black men; 34.7% in white men; 23.1% in black women; 25.2% in white women), Howard and colleagues wrote.
Women aged 45 to 64 years, for both races, had lower stroke risk than men (incidence rate ratio [IRR] for white women vs. white men = 0.68; 95% CI, 0.49-0.94; IRR for black women vs. black men = 0.72; 95% CI, 0.52-0.99), according to the researchers.
However, for women aged 65 to 74 years, the lower risk persisted in white adults but not in black adults (IRR for white women vs. white men = 0.71; 95% CI, 0.55-0.94; IRR for black women vs. black men = 0.94; 95% CI, 0.68-1.3), although the race-sex interaction was not significant, Howard and colleagues wrote.
At age 75 years or older, there was no difference in stroke risk by sex for either race.
Howard and colleagues also found that there were no sex differences for any stroke risk factors in black adults.
However, for white adults, the following associations with stroke risk were greater for women than for men: systolic BP (P for interaction = .099), diabetes (P for interaction = .02) and heart disease (P for interaction = .09), whereas the antihypertensive medication use had a greater association with stroke risk in men than in women (P for interaction = .08), according to the researchers.
“We hope this will encourage people and their primary care physicians to have more discussions, and to ‘target’ their discussion on risk factors of more importance to the patient — about stroke risk factors and what can be done to prevent the risk factor from occurring,” Howard said in the release. “Or if someone already has risk factors, the discussion can be geared toward better management and control of risk factors. This is true across all race-sex-age groups.” – by Erik Swain
Disclosure: One author reports receiving personal fees from AbbVie and Janssen.
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