The relation of gender to modifiable risk factors for stroke

Kathryn K McCaslin, The University of Texas School of Public Health


Stroke is a major cause of mortality and disability in the United States. Stroke has been deemed a dimorphic disease with each sex presenting with distinct patterns across the lifespan (Gottesman & Hillis, 2010). With females suffering greater mortality and adverse outcomes from stroke than males (Rosamond et al., 2008), more attention is needed to determine sex-specific risk factors for stroke. The following project examines if sex differences exist in modifiable risk factors for stroke, in a cohort of hospital based stroke patients. ^ The study was conducted at the Seton Stroke Institute in Austin, TX utilizing the Get with the Guidelines- Stroke database at Seton Healthcare. Data abstracted from 811 patients’ electronic medical records were utilized to assess the prevalence and association of modifiable risk factors with stroke severity, by sex among incident stroke cases. Covariates were then summarized in predictive models for severe strokes. The influence of diabetes in stroke models was also assessed, considering the condition as an effect measure modifier. ^ The results suggest that men had a greater prevalence of alcohol/drug abuse, diabetes, obesity, and smoking in their medical histories while women had a greater prevalence of hypertension. Chi square tests conducted for conditions of interest for each gender, revealed mean arterial pressure and hypertension management for males, and diabetes for females, were predictors of severe stroke at the p< 0.05 alpha level. In creating predictive models for stroke in each gender, both the male (p=.01) and female (p=.01) models were significant after adjusting for age. After age-adjusting each gender’s logistic regression model, mean arterial pressure was not a statistically significant predictor of severe stroke (p=0.11) for males and fasting blood sugar was not a statistically significant predictor of severe stroke (p=.07) in females. Examining the role of third variables, diabetes as defined by fasting blood sugar of 126mg/dL or greater, was an effect measure modifier for severe stroke, with diabetic status posing a 3.29 times greater risk of severe stroke. ^ Although the majority of the findings for this study were null, this analysis may generate further research in the area of modifiable risk factors for stroke, considering their role in each sex.^

Subject Area

Health sciences|Public health|Epidemiology

Recommended Citation

McCaslin, Kathryn K, "The relation of gender to modifiable risk factors for stroke" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10127425.