Evidence map›Paper›PMID 27382006›Full record

ArticleStroke2016

Hemoglobin Concentration and Risk of Incident Stroke in Community-Living Adults.

Bhupesh Panwar, Suzanne E Judd, David G Warnock, William M McClellan, John N Booth, Paul Muntner, Orlando M Gutiérrez

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Bhupesh PanwarFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.).
Suzanne E JuddFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.).
David G WarnockFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.).
William M McClellanFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.).
John N BoothFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.).
Paul MuntnerFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.).
Orlando M GutiérrezFrom the Departments of Medicine (B.P., D.G.W., J.N.B., P.M., O.M.G.), Biostatistics (S.E.J.), and Epidemiology (J.N.B., P.M., O.M.G.), University of Alabama at Birmingham; and Departments of Epidemiology and Medicine, Emory University, Atlanta, GA (W.M.M.). ogutierrez@uabmc.edu.
Emory University · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
UAB-UCSD O'Brien Core Center for Acute Kidney Injury ResearchP30DK079337 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AGARWAL, ANUPAM · 2008 to 2022
$18.3M
Impact of disordered mineral metabolism on stroke and cognitive impairmentR01NS080850 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M · 2012 to 2016
$1.2M
NIDDK NIH HHS P30 DK079337NINDS NIH HHS R01 NS080850NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

background and purposeIn previous observational studies, hemoglobin concentrations have been associated with an increased risk of stroke. However, these studies were limited by a relatively low number of stroke events, making it difficult to determine whether the association of hemoglobin and stroke differed by demographic or clinical factors.

methodsUsing Cox proportional hazards analysis and Kaplan-Meier plots, we examined the association of baseline hemoglobin concentrations with incident stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white adults aged ≥45 years.

resultsA total of 518 participants developed stroke over a mean 7±2 years of follow-up. There was a statistically significant interaction between hemoglobin and sex (P=0.05) on the risk of incident stroke. In Cox regression models adjusted for demographic and clinical variables, there was no association of baseline hemoglobin concentration with incident stroke in men, whereas in women, the lowest (<12.4 g/dL) and highest (>14.0 g/dL) quartiles of hemoglobin were associated with higher risk of stroke when compared with the second quartile (12.4-13.2 g/dL; quartile 1: hazard ratio, 1.59; 95% confidence interval, 1.09-2.31; quartile 2: referent; quartile 3: hazard ratio, 0.91; 95% confidence interval, 0.59-1.38; quartile 4: hazard ratio, 1.59; 95% confidence interval, 1.08-2.35). Similar results were observed in models stratified by hemoglobin and sex and when hemoglobin was modeled as a continuous variable using restricted quadratic spline regression.

conclusionsLower and higher hemoglobin concentrations were associated with a higher risk of incident stroke in women. No such associations were found in men.

Indexed as

AgedAged, 80 and overBlack PeopleFemaleHemoglobinsHumansIncidenceMaleMiddle AgedRiskSex FactorsStrokeWhite PeopleHemoglobinsanemiacohort studieshematocrithemoglobinsrenal insufficiency, chronicstroke

Identifiers

PMID27382006
PMCPMC4961542
OpenAlexW2469783431

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.