Predictive value and robustness of the stress hyperglycemia ratio combined with hypertension for stroke risk: evidence from the China Health and Retirement Longitudinal Study (CHARLS) cohort
Main finding · Incident strokeResult — go to the resultHazard ratio 2.94 95% CI 2.38–3.64Authors' conclusion
Elevated SHR is independently associated with an increased risk of stroke, and its predictive value is enhanced when combined with hypertension. SHR may serve as an integrated metabolic marker reflecting both acute stress and chronic risk burden. Incorporating SHR into stroke risk assessment tools may improve early identification and enable more targeted prevention strategies, particularly in hypertensive populations.
Study context
- Population
- Stroke-free participants aged ≥45 years from the 2011 baseline of CHARLS, followed through 2020
- Participants
- 9,682 participants
- Exposure
- Combined stress hyperglycemia ratio (SHR) and hypertension categories vs low SHR without hypertension
- Outcome
- Incident stroke
- Follow-up
- Median 8.43 years
Main finding
As reported in the abstract
Hazard ratio
2.94
95% CI 2.38–3.64
High SHR + hypertensionvs Low SHR without hypertension
HR 2.94 (95% CI 2.38–3.64)
Observational data: associations, not effects.
Further findings
Subgroup analyses by sex and age
- Consistent findings across sex and age strata
Discrimination of combined SHR-hypertension model
- AUC (improved discriminative ability)
- 0.653
Sensitivity analyses
- Confirmed robustness of the results
Original publication
Predictive value and robustness of the stress hyperglycemia ratio combined with hypertension for stroke risk: evidence from the CHARLS cohort. Cardiovasc Diabetol. Published 18 August 2025. doi:10.
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