Abstract P245: Sex Differences in the Association Between Cardiovascular Risk Profiles and Hospitalizations/ED Visits Among Patients With a History of Stroke/TIA

Abstract

Background: Secondary prevention addressing cardiovascular risk factors is a key care component for reducing the risk of vascular events among those who had a stroke/TIA. We assessed cardiovascular risk factor (CVD-RF) profiles and their impact on hospitalizations and Emergency Department (ED) visits and whether the association differs for men and women with prior stroke/TIA. Methods: We used data from the nationally representative Medical Expenditure Panel Survey (2012-2015) for persons aged ≥ 18 years with a prior stroke/TIA. CVD-RF score included 6 self-reported factors (hypertension, diabetes, high cholesterol, lack of exercise, smoking, obesity), categorized as low (0-1 factors), intermediate (2-3), or high (4-6). Outcomes included ≥ 1 hospitalization discharges or ED visits during the participant’s survey year. Multivariable logistic regression models assessed the association between CVD-RF scores and outcomes, stratified by sex. We tested for interaction by sex in a combined model with men and women. Results: The weighted sample represents 9.9 million individuals (mean age 65.1 years; 54.3% women). Overall, 16.7%, 59.3%, and 24.1% of men had low, intermediate, and high CVD-RF scores compared to 21.6%, 59.5%, and 18.9% of women. Among men, there was no significant association between CVD-RF score and the two outcomes ( Table ). Among women, even after adjustment for covariates, those with high scores had 1.89 and 2.06-fold increases in the odds of hospitalizations and ED visits, compared to those with low CVD-RF scores ( P <0.05). Furthermore, women with intermediate CVD-RF scores had a 1.68-fold increase in the odds of ED visits compared to those with low scores ( P <0.05). The combined model showed a significant interaction by sex. Conclusion: Women with increased CVD-RF scores had increased odds of ED visits and hospitalizations, which could be due to less effective secondary prevention. Further research is needed to explore reasons for this sex disparity.