| Objective To explore the risk factors of cerebral hemorrhage in different sexes,and to provide basis for more targeted prevention of cerebral hemorrhage,rational formulation of evidence-based health care planning,and scientific allocation of medical resources.Methods In this prospective cohort study,people were selected from the ‘2006-2007 health examination records' in kailuan,and had no history of stroke,malignant tumors and signed the informed consent.From the time of the first physical examination,the follow-up was terminated on December 31,2016.All the subjects included in the analysis collected their general data,physical measurement indicators,laboratory indicators and calculated relevant indicators according to the formula(body mass index,waist-to-hip ratio,etc.).Every year,through the medical records system,case files and the social security information system of the 11 hospitals under the Kailuan General Hospital and the Kailuan Group,the cerebral hemorrhage event was investigated to record the general information and onset time of patients with new cerebral hemorrhage.Use the Epidata3.1 software for data entry and SAS 9.4 and SPSS22.0 version software for statistical analysis.The KaplanMeier cumulative survival rate curve was drawed,and use the log-rank test to compare the survival curves of male and female cerebral hemorrhage.Taking the cerebral hemorrhage as dependent variable,age,sex,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,central obesity,hypertension,diabetes mellitus,smoking,drinking,salt habit,physical exercise,labor type,education level,kidney damage and anemia as independent variables,the Cox proportional hazard ratios were calculated to assess relative risk of cerebral hemorrhage events among different sexes.And to calculate the population-attributable risk of cerebral hemorrhage between male and female population.Results 1 A total of 98961 subjects were included in the statistical analysis,with an average age of(51.11±12.61)years,including 78908 males(79.7%)and 20053 females(20.3%).During a median of 10.00±0.73 years of follow-up,a total of 860 cerebral hemorrhage events.The incidence of cerebral hemorrhage was 86.90/10 million person years(standardized incidence rate of 47.85/10 million person years).752 cases(87.44%)occurred in males and 108 cases(12.56%)in females.The incidence of cerebral hemorrhage in male(49.61/10 million person years)was higher than that of female(34.07/10 million person years).2 The Cox proportional hazards models showed that after adjusting for confounding factors,age,gender,central obesity,hypertension,diabetes mellitus,educational level and kidney damage were associated with cerebral hemorrhage.The male are 1.41 times(95%CI: 1.13-1.77)more likely to have cerebral hemorrhage than female.3 Gender stratified Cox regression analysis found that: Age,central obesity,hypertension and diabetes were all related factors in the onset of cerebral hemorrhage in males and females(P<0.05),but the degree of association with cerebral hemorrhage was different.45-59 years of age,over 60 years,central obesity and diabetes were more strongly related to new-onset of cerebral hemorrhage events in female than male,and the hazard ratios(95%CI)were2.49(1.29-4.80),3.03(1.41-6.51),8.01(1.14-16.09)and 1.72(1.02-2.91)in female versus,1.65(1.29-2.11),2.37(1.81-3.08),3.00(1.00-8.95)and 1.24(1.00-1.55)in male,respectively.The risk of male cerebral hemorrhage increased by 29%(HR=1.29,95% CI:1.19-1.40)when the systolic blood pressure increased at 10 mmHg,which was higher than that of female 24%(HR=1.24,95% CI: 1.20-1.28).However,the correlation between hypertension and the incidence of cerebral hemorrhage in males(HR=2.73,95% CI: 2.28-3.27)was higher than that in females(HR=2.42,95% CI: 1.55-3.77).Salt habits were only related to the incidence of cerebral hemorrhage in women(HR = 4.42,95% CI: 1.22-16.11).Educational level(high school or technical secondary school,university or above compared with not attending school)and kidney damage were only related to the incidence of male cerebral hemorrhage [HR(95% CI)were 0.54(0.32-0.92),0.46(0.23-0.95),1.39(1.18-1.65)].4 Cerebral hemorrhage of PAR% found: After eliminating the three adjustable factors of hypertension,diabetes,and central obesity,the incidence of cerebral hemorrhage in females may be reduced by 69.45%(95% CI: 51.37-80.95);and after eliminating the four adjustable factors of hypertension,diabetes,central obesity and kidney damage,the incidence of cerebral hemorrhage in males may be reduced by 54.29%(95% CI: 43.00-63.51).5 On the basis of the general population,those who took antiplatelet drugs and/or anticoagulants(who had a history of coronary heart disease and/or atrial fibrillation)and those who took antihypertensive,hypoglycemic,and lipid-lowering drugs were excluded.Then,repeated Cox proportional hazard model analysis showed that the risk of cerebral hemorrhage in males was still higher than that in females;age,gender,central obesity,hypertension,diabetes mellitus,educational level and kidney damage were related to the incidence of cerebral hemorrhage;hypertension and kidney damage were more related to the incidence of male cerebral hemorrhage;age,diabetes mellitus and salt habit were related to the incidence of female cerebral hemorrhage.Conclusions 1 The incidence and risk of cerebral hemorrhage in male population were higher than that in female population.2 Age,central obesity,hypertension and diabetes are the common factors affecting the incidence of cerebral hemorrhage in men and women.The incidence of cerebral hemorrhage in men is more closely related to hypertension,while age,central obesity,diabetes are more closely related to the incidence of cerebral hemorrhage in women.3 Educational level and renal damage were only associated with the incidence of cerebral hemorrhage in male population,while salt habit was only associated with the incidence of cerebral hemorrhage in female population Figure 1;Table 13;Reference 173. |
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