Sex differences in the association between diabetes and hypertension and the risk of stroke: cohort of the Tehran Lipid and Glucose Study.

ABSTRACT

BACKGROUND: We assessed the sex differences in the association between blood pressure categories and glucose intolerance status with overall and ischemic stroke among Iranian adults. METHODS: This prospective study was conducted on 5349 individuals (2446 men) aged ≥ 40 years. Cox models were used to estimate adjusted hazard ratios (HRs) and men-to-women ratios of HRs (RHRs) of overall and ischemic stroke for systolic (SBP) and diastolic (DBP) blood pressure, pre-hypertension, hypertension, fasting plasma glucose (FPG), pre-diabetes and type 2 diabetes (T2D). RESULTS: Each 0.55 mmol/L increase in FPG was associated with a higher HR of overall stroke in men than women [RHRs 1.05 (1.01-1.09)]. The associations between each 10 mmHg increase in DBP and stroke events were stronger in men than women, with RHRs of 1.20 (1.00-1.45) and 1.29 (1.04-1.60) for overall and ischemic stroke, respectively. Hypertension was associated with a higher HR of overall [RHRs 2.41 (1.21-4.8)] and ischemic stroke [2.37 (1.12-5.01)] in men than women. We also found that T2D was associated with higher risks of overall and ischemic stroke in men than women the RHRs were 2.16 (1.24-3.75) and 1.93 (1.05-3.55) for overall and ischemic stroke, respectively. CONCLUSION: Hypertension and T2D induced higher risk of overall and ischemic stroke in men than women among Iranian population.