Department of Public Health, China Medical University, Taichung, Taiwan.
Department of College Pharmacy and Health Care, Tajen University, Pintung, Taiwan.
PLoS One. 2019 Nov 12;14(11):e0225221. doi: 10.1371/journal.pone.0225221. eCollection 2019.
Dysmenorrhea and stroke are health problems affecting women worldwide in their day-to-day lives; however, there is limited knowledge of the stroke risk in women with dysmenorrhea, and there have been no studies assessing the specific distribution of stroke subtypes. This case-control study assessed stroke subtypes by age and the role of comorbidities in women with dysmenorrhea.
Data obtained between 1997 and 2013 from Taiwan's health insurance database identified 514 stroke cases and 31,201 non-stroke controls in women with dysmenorrhea aged 15-49 years. Proportional distributions of subtypes and odds ratios (ORs) of stroke associated with comorbidities by age and subtype were measured. We found that the stroke risk in dysmenorrheal patients increased with age, and that hypertension was nine-fold more prevalent in the stroke cases than in the controls and was associated with an adjusted OR of 4.53 (95% confidence interval (CI) = 3.46-5.92) for all stroke cases. Moreover, the proportion of hemorrhagic stroke was greater than that of ischemic stroke in younger dysmenorrheal patients between 15-24 years old (50.5% vs. 11.4%), whereas this was reversed in those aged 30-49 years old (16.1% vs. 21.0%). Overall, 25.3% of the stroke cases consisted of transient cerebral ischemia and 31.3% were other acute but ill-defined cerebrovascular diseases, in which the prevalence increased with age for both types of strokes. Hypertension was the comorbidity with the highest OR associated with each subtype stroke; diabetes, hyperlipidemia, arrhythmia, and thyroid disease were also comorbidities that were significantly associated with ill-defined cerebrovascular diseases.
The stroke type varies by age in dysmenorrheal patients, and hypertension is the most important comorbidity associated with all types of stroke; therefore, more attention for stroke prevention must be paid to women with dysmenorrhea, particularly when combined with comorbidities.
痛经和中风是影响全球女性日常生活的健康问题；然而，对于痛经女性的中风风险知之甚少，也没有研究评估中风亚型的具体分布。本病例对照研究评估了痛经女性中风亚型的年龄分布及合并症的作用。
1997 年至 2013 年间，从台湾健康保险数据库中获取了 514 例中风病例和 31201 例非中风对照组，年龄在 15-49 岁的痛经女性。按年龄和亚型测量了各亚型的比例分布和中风相关的比值比（OR）。我们发现，痛经患者的中风风险随年龄增长而增加，且中风病例中高血压的患病率是对照组的 9 倍，调整后的所有中风病例的 OR 为 4.53（95%置信区间（CI）=3.46-5.92）。此外，15-24 岁年轻痛经患者中出血性中风的比例高于缺血性中风（50.5%比 11.4%），而 30-49 岁的患者则相反（16.1%比 21.0%）。总体而言，中风病例中有 25.3%为短暂性脑缺血发作，31.3%为其他急性但不明原因的脑血管病，两种类型的中风患病率均随年龄增长而增加。高血压是与各亚型中风相关性最高的合并症；糖尿病、高脂血症、心律失常和甲状腺疾病也是与不明原因脑血管病显著相关的合并症。
痛经患者的中风类型随年龄而异，高血压是与所有类型中风最相关的合并症；因此，必须更加关注痛经女性的中风预防，特别是当合并症时。
