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中国男性和女性在原发性和继发性中风预防策略上的差异。

Differences in primary and secondary stroke prevention strategies for Chinese men and women.

作者信息

Xie Zenghua, Guo Xu, Han Liyuan, Wang Xin, Yan Qianqian, Shu Chang, Fan Zhenyi, Zhao Miaomiao

机构信息

Department of Neurology, Beilun District People's Hospital, Ningbo, Zhejiang, China.

Department of Rehabilitation Medicine, Hwa Mei Hospital, University of the Chinese Academy of Sciences, Ningbo, Zhejiang, China.

出版信息

Prev Med Rep. 2023 Apr 26;33:102219. doi: 10.1016/j.pmedr.2023.102219. eCollection 2023 Jun.

Abstract

This study aimed to explore whether stroke prevention strategies differ for men and women. Data used were from China Kadoorie Biobank. According to the China-PAR Project model, a predicted 10-year stroke risk of ≥7% is defined as a high stroke risk. The effects of risk factor control and medication use as primary and secondary stroke prevention strategies were assessed, respectively. Logistic regression models were used to assess the sex-specific differences in the primary and secondary stroke prevention practices. Of the 512,715 participants (59.0% women), 218,972 (57.4% women) had a high risk of stroke and 8884 (44.7% women) had an established stroke. Of high-risk participants, women were considerably less likely than men to receive antiplatelets (odds ratio [OR], 0.80; [95% confidence interval, CI, 0.72-0.89]), antihypertensives (0.46[0.44-0.48]), and antidiabetics (0.65[0.60-0.70]). Meanwhile, stroke women were significantly less likely to receive antiplatelets (0.75[0.65-0.85]) but more likely to receive antidiabetics (1.56 [1.34-1.82]) than their male counterparts. Besides, differences were found in risk factor control between women and men. Sex-specific differences in stroke prevention strategies are prevalent in China. Effective prevention requires the implementation of better overall nationwide strategies and special emphasis on women.

摘要

本研究旨在探讨男女之间的卒中预防策略是否存在差异。所使用的数据来自中国嘉道理生物银行。根据中国-PAR项目模型,预测10年卒中风险≥7%被定义为高卒中风险。分别评估了作为一级和二级卒中预防策略的危险因素控制和药物使用的效果。采用逻辑回归模型评估一级和二级卒中预防措施中的性别差异。在512,715名参与者中(女性占59.0%),218,972名(女性占57.4%)有高卒中风险,8884名(女性占44.7%)已发生卒中。在高风险参与者中,女性接受抗血小板药物治疗的可能性显著低于男性(比值比[OR],0.80;[95%置信区间,CI,0.72 - 0.89])、接受降压药物治疗的可能性(0.46[0.44 - 0.48])以及接受抗糖尿病药物治疗的可能性(0.65[0.60 - 0.70])。同时,与男性卒中患者相比,女性卒中患者接受抗血小板药物治疗的可能性显著降低(0.75[0.65 - 0.85]),但接受抗糖尿病药物治疗的可能性更高(1.56 [1.34 - 1.82])。此外,发现男女在危险因素控制方面存在差异。在中国,卒中预防策略的性别差异普遍存在。有效的预防需要实施更好的全国性整体策略,并特别关注女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5686/10201908/41aeeacc6816/gr1.jpg

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