Incidence, severity of stroke elevated in women, other groups
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Women, older individuals and those living in lower socioeconomic areas have a higher incidence of stroke and subsequent major adverse outcomes, researchers reported.
“There is a lack of contemporary evidence from nationally representative data across the entire spectrum of both primary and secondary care to assess demographic variations in the incidence of first nonfatal stroke,” Ralph K. Akyea, MBChB, MPH, of the division of primary care at the University of Nottingham, U.K., and colleagues wrote in Stroke. “We sought to update current knowledge on differences in nonfatal stroke incidence and incidences of major adverse outcomes following first nonfatal stroke event.”
The cohort study included 82,774 first nonfatal stroke events from 1998 to 2017 obtained from the Clinical Practice Research Datalink and Hospital Episode Statistics from the U.K. Researchers calculated the incidence rate ratio of first nonfatal stroke and subsequent major adverse outcomes presented by year, sex, age group and socioeconomic status based on location of residence.
There was an incidence rate of 109.2 per 100,000 person-years for stroke among the cohort, with the incidence being higher among women compared with men (incidence rate ratio [IRR] = 1.13; 95% CI, 1.12-1.15; P < .001). After adjustment for age and sex, incidence rates were higher in the lowest socioeconomic group compared with the highest socioeconomic group (IRR = 1.1; 95% CI, 1.08-1.13; P < .001).
For subsequent major adverse outcomes in the cohort, overall incidence for a major adverse CV event was 38.05 per 100 person-years, demonstrating a slightly higher incidence of 38.42 among women compared with 37.62 among men (IRR = 1.02; 95% CI, 1-1.04; P = .0229). The observed higher incidence of adverse outcomes in women was largely explained by age and socioeconomic status, the researchers wrote.
These findings demonstrate that the greater burden of major adverse outcomes found in women compared with men after first nonfatal stroke is largely accounted for by age and socioeconomic status, according to the researchers.
“Public health policies and future clinical research needs to investigate why this may occur, with a particular need to address disparities in outcomes for women and deprived populations,” they wrote. “Evidence of variation in major adverse outcomes post-stroke by demographic and socioeconomic characteristics offers the opportunity to tailor secondary prevention and prioritize limited health care resources to those at greatest risk.”
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