Abstract TP196: A Decade Later: Revisiting The Midlife Stroke Surge Among Women In The United States; Updated Results From The National Health And Nutrition Examination Surveys (NHANES)

Background: Previous data from NHANES 1999-2004 showed that women aged 45-54 years were more than twice as likely as men to report a prior stroke. Little is known about recent sex-specific trends in midlife stroke prevalence and risk factors for stroke. Methods: We assessed age- and sex- specific trends in stroke prevalence among individuals aged 35-64 years (n= 23,936; weighted n= 349,074,769) participating in NHANES across epochs in 6-year intervals (1999-2004, 2005-2010, 2011-2016) using survey weighted counts and proportions to reflect US national estimates. Stroke was self-reported. Survey adjusted logistic regression models compared odds of prior stroke by sex across time for each midlife decade adjusting for sociodemographic and clinical variables. Trends in prevalence of vascular risk factors were assessed over time. Results: In 1999-2004, women aged 45-54 years were over twice as likely as men to report prior stroke (OR 2.4, 95% CI 1.4-4.2, p=0.002). In 2005-2010 and 2011-2016, the differences were no longer significant (OR 1.5, 0.9-2.5, p=0.15 and OR 0.9, 0.5-1.6, p=0.71). There were no sex differences in stroke prevalence for those aged 35-44 and 55-64 years (Table). Among those aged 45-54 years, mean systolic blood pressure (SBP) were comparable between women and men in 1999-2004 (124, SE 0.7 mmHg vs 125, SE 0.6 mmHg, p= 0.27), but women’s mean SBP decreased to 121, SE 0.6 mmHg in 2011-2016, while men’s remained stable at 124, SE 0.6 mmHg. Diabetes prevalence increased in both men (9% to 13%) and women (8% to 10%). Obesity prevalence increased from 31% to 38% in men and 37% to 42% in women. Conclusion: A decade later the midlife stroke prevalence surge among women (vs. men) in the US has abated. However, it is unclear whether this change is due to shifts in incidence or case fatality and opportunities remain to address cardiometabolic risk factors for both sexes.