Sex differences in blood pressure after stroke: a systematic review and meta-analysis.

Abstract:

OBJECTIVES:Evidence about sex differences in blood pressure (BP) at the time of acute stroke presentation is scarce. We aimed to summarize available data on sex differences in BP at the time of acute stroke presentation, including stratification by prior history of hypertension and stroke subtype. METHODS:We performed a systematic literature search across MEDLINE and Embase, from inception to 21 December 2018, to identify all population-based observational studies that reported BP at the time of acute stroke presentation. We extracted data on patient demographics, stroke-type (ischaemic or haemorrhagic), stroke severity, vascular risk factors, and SBP and DBP at the time of stroke presentation. Wherever possible, data were pooled for meta-analysis with weighted mean difference (WMD) and corresponding 95% confidence intervals (CI) using random effects meta-analysis. RESULTS:We included 128 138 stroke patients from 43 studies. Women had higher SBP at presentation than men (WMD, 1.46; 95% CI, 0.65-2.26); this difference was significant in ischaemic stroke (1.49; 0.25-2.72 mmHg), but not in intracerebral haemorrhage (0.19; -4.21 to 4.59 mmHg). Meta regression show that sex differences in SBP were consistent with increasing age, stroke severity, other comorbidities and medication history. CONCLUSION:This systematic review and meta-analysis indicates that women have higher SBP at the time of presentation with acute stroke. These differences are consistent with sex differences in hypertension patterns in older age, and may be explained by the fact that women are more likely to have a premorbid hypertension. This highlights the need for effective sex-specific blood pressure control in patients at high risk for stroke.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Li J,Yang SC,Moullaali TJ,Chen R,Woodward M,Carcel C,Delcourt C,Sandset EC,Anderson C,Chen G,Wang X

doi

10.1097/HJH.0000000000002116

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

1991-1999

issue

10

eissn

0263-6352

issn

1473-5598

journal_volume

37

pub_type

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