Sex Differences in Severity and Risk Factors for Ischemic Stroke in Patients With Hyperlipidemia

Abstract

Objective: This study aims to determine sex differences in poststroke hypertriglyceridemia (serum triglyceride levels ⩾ 200 mg/dl) and high stroke severity in ischemic stroke patients.

Method: Our study analyzed data from 392 males and 373 females with hypertriglyceridemia. Stroke severity on admission was measured using the National Institute of Health Stroke Scale (NIHSS) with a value ⩽7 indicating a more favorable post-stroke prognosis while a score of >7 indicates poorer post-stroke outcomes. Logistic regression models adjusted for demographic and risk factors. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each clinical risk factor were used to predict the increasing odds of an association of a specific clinical baseline risk factor with the male or female AIS with hypertriglyceridemia.

Results: In the adjusted analysis, male patients with hypertriglyceridemia, diastolic blood pressure (OR = 1.100, 95% CI, 1.034-1.171, P = .002), and Ischemic stroke mortality (OR = 6.474, 95% CI, 3.262-12.847, P < .001) were significantly associated with increased stroke severity. In female patients with hypertriglyceridemia, age (OR = 0.920, 95% CI, 0.866-0.978, P = .008) was associated with reduced stroke severity, while ischemic stroke mortality score (OR = 37.477, 95% CI, 9.636-145.756, P < .001) was associated with increased stroke severity.

Conclusion: Increased ischemic stroke mortality risk score was associated with increased severity in both male and female AIS patients with hypertriglyceridemia. Our findings provide information about sex differences in specific risk factors that can be managed to improve the care of male and female ischemic stroke patients with hypertriglyceridemia.

Keywords: Ischemic stroke; NIHSS; hypertriglyceridemia; sex.

Figure 1.

Forest plot representation of clinical and demographic factors for male or female ischemic stroke patients in the whole stroke population with elevated triglyceride levels ⩾ 200 mg/dl. Odd ratio below 1 denotes factors that are associated with females while odd ratio above 1 denotes factors that are associated with males. *Indicates statistical significance (P < .05) with a 95% confidence interval.

Figure 2.

Forest plot representation of clinical and demographic factors for male ischemic stroke patients with elevated triglyceride level ⩾ 200 mg/dl. Odd ratio below 1 denotes factors that are associated with a NIHSS score ⩽ 7 while odd ratio above 1 denotes factors that are associated with a NIHSS score > 7. *Indicates statistical significance (P < .05) with a 95% confidence interval.

Figure 3.

Forest Plot representation of clinical and demographic factors for female ischemic stroke patients with elevated triglyceride level ⩾ 200 mg/dl Odd ratio below 1 denotes factors that are associated with an NIHSS score ⩽ 7 while an odd ratio above 1 denotes factors that are associated with a NIHSS score > 7. *Indicates statistical significance (P < .05) with a 95% confidence interval.