Are there sex-based differences in secondary prevention target attainment after a first-ever ischemic stroke?
1,987 patients aged ≥15 years with first-ever ischemic stroke (ICD-10: I63) from the primary healthcare cardiovascular program of the Talcahuano Health Service (Chile) during 2016-2024. Mean age 69.2 years, 51.2% female, 73.9% low socioeconomic status.
Female sex
Male sex
Secondary prevention target attainment (systolic blood pressure, fasting blood glucose, HbA1c, physical inactivity, BMI, LDL cholesterol, alcohol use disorder, current smoking)surrogate
Significant sex-based differences exist in secondary prevention goal attainment after ischemic stroke, with females having higher rates of physical inactivity, BMI, and LDL, while males have higher rates of smoking and alcohol use.
Abstract Background and aims Achieving secondary prevention goals after stroke is essential, and substantial evidence supports their effectiveness in reducing recurrent risk. We examined sex-based differences in secondary prevention target attainment after a first-ever ischemic stroke(IS). Methods Retrospective cohort study using Chilean database from the primary healthcare cardiovascular program of the Talcahuano Health Service during 2016-2024. Patients aged ≥15years with first-ever IS (ICD-10:I63) were included. Sex-differences were assessed using multivariable models adjusted for age and socioeconomic status (SES). Adjusted odds ratios (aORs) and adjusted mean differences (aMeanD) were reported with 95% confidence intervals (95% CI) (Stata v.19.0). Results Among 86,050 program participants, 1,987 IS patients were identified, 51.2% were females, mean age 69.2 years, and 73.9% had low SES. Similar outcomes by sex were observed in the mean of systolic blood pressure (females:135.5 mmHg vs males:136.3mmHg), fasting blood glucose (126.6mg/dl vs 125.6mg/dl), and HbA1c (7.7%vs7.7%). Females were more likely than males to have physical inactivity (81.0%vs 72.3%; aOR:1.6 (95%CI:1.3 to 2.0)), higher mean body mass index (30.9kg/m2 vs 28.8kg/m2; aMeanD:2.1kg/m2 (1.7 to 2.6)), and higher mean LDL cholesterol (84.5mg/dL vs 78.6mg/dL; aMeanD:5.8mg/dL (2.3 to 9.4)). In contrast, males were more likely to have an alcohol use disorder (2.3%vs10.0%; aOR:0.2 (0.1 to 0.3)), and current smoking (13.2%vs 20.7%; aOR:0.6 (0.4 to 0.7)). Conclusions Secondary prevention goal attainment remains suboptimal, and sex-related differences were identified, underscoring the need for sex-specific prevention strategies. Conflict of interest The authors declare that they have nothing to disclose related to this abstract. Figure 1 - belongs to Conclusions
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Marilaura Núñez
Freddy Constanzo
Cristóbal Alvarado Livacic
European Stroke Journal
Vall d'Hebron Institut de Recerca
Clínica Alemana
Universidad del Desarrollo
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Núñez et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7f86bfa21ec5bbf08032 — DOI: https://doi.org/10.1093/esj/aakag023.479
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