Association between the sarcopenia index and the risk of stroke in elderly patients with hypertension: a cohort study

The purpose of this study was to investigate the relationship between the sarcopenia index (SI) and stroke risk in elderly patients with hypertension. This study included 5145 stroke-free elderly hypertensive patients. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident stroke. Over a median follow-up of 38 months, we identified 607 (11.80%) individuals with total stroke, of whom 507 (9.85%) had ischemic stroke and 93 (1.81%) had hemorrhagic stroke. The risk of developing stroke decreased with each quartile of SI; after adjustment for multiple confounders, the HRs for the Q4 group versus the Q1 group were 0.46 (95% CI, 0.35–0.59) for total stroke, 0.46 (95% CI, 0.35–0.61) for ischemic stroke, and 0.33 (95% CI, 0.17–0.64) for hemorrhagic stroke. Restricted cubic spline analysis also demonstrated a cumulative increase in the risk of total stroke with decreases in the SI. The addition of SI to the conventional model for total stroke improved (ΔC-statistics = 0.02), an integrated discrimination improvement of 0.03 (95% CI, 0.02–0.04), and a net reclassification improvement of 0.17 (95% CI, 0.10–0.23). Similar results were observed for ischemic stroke and hemorrhagic stroke. This study found that elevated SI was negatively associated with the risk of stroke in elderly patients with hypertension. Uncovering the causality behind the relationship requires further prospective study.