Sex Differences of Combined Effects Between Hypertension and General or Central Obesity on Ischemic Stroke in a Middle-Aged and Elderly Population
Authors Chen MQ, Shi WR, Wang HY, Sun YX
Received 6 December 2020
Accepted for publication 3 February 2021
Published 10 March 2021 Volume 2021:13 Pages 197—206
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Eyal Cohen
Meng-Qi Chen,1 Wen-Rui Shi,1 Hao-Yu Wang,2 Ying-Xian Sun1
1Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China; 2Department of Cardiology, Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, People’s Republic of China
Correspondence: Ying-Xian Sun
Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, People’s Republic of China
Email [email protected]
Background: Hypertension and obesity are recognized as modifiable risk factors for stroke, but their combined effects are unknown. This study aimed to explore the combined effects of hypertension and general or central obesity on the risk of ischemic stroke in a middle-aged and elderly population.
Methods: The data of 11,731 participants (53.5 ± 10.5 years old) were analyzed from the Northeast China Rural Cardiovascular Health Study, 2012– 2013. General obesity (GO) was defined by body mass index (BMI); central obesity (CO) was measured by waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR).
Results: The overall prevalence of ischemic stroke was 3.1%. After adjusting for age and sex, the odds ratios for having ischemic stroke were 4.31 (3.14– 5.91) among subjects with hypertension, 1.79 (1.40– 2.30) with GO, 1.94 (1.54– 2.43), 1.98 (1.54– 2.53), and 1.65 (1.33– 2.06) with CO measured by WC, WHtR and WHpR, respectively. After full adjustment for potential confounders, the combinations of hypertension and obesity indices (including BMI, WC, WHtR and WHpR) were associated with the highest risk of ischemic stroke, especially in women, which were respectively 7.3-fold, 9.3-fold, 9.9-fold and 7.6-fold higher than that of individuals without both conditions.
Conclusion: Our study results suggest that women with both hypertension and obesity, no matter defined by BMI, WC, WHtR or WHpR, were more likely to have ischemic stroke. A better understanding of the combined effects of these risk factors can help promote primary prevention in susceptible subgroups.
Keywords: ischemic stroke, hypertension, general obesity, central obesity
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]