{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T21:46:04Z","timestamp":1791755164855,"version":"4.3.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Zhejiang Provincial Vanguard Geese Leading Plan Project","award":["2025C02105"],"award-info":[{"award-number":["2025C02105"]}]},{"name":"the Basic Public Welfare Research Project of Zhejiang Province","award":["LGF22H150003"],"award-info":[{"award-number":["LGF22H150003"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Previous studies that have used data from the China Health and Retirement Longitudinal Study have linked the platelet-to-high-density lipoprotein cholesterol ratio to stroke in broader middle-aged and older populations. We evaluated whether this association persisted among adults with hypertension who were stroke-free at baseline and assessed platelet count and high-density lipoprotein cholesterol levels separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective secondary analysis used longitudinal data from the China Health and Retirement Longitudinal Study, with 2011 as the baseline year and 2013, 2015, 2018, and 2020 as the follow-up years. The primary cohort included 3963 adults aged \u226545 years who met the criterion for hypertension at baseline and were explicitly stroke-free at baseline and for whom complete and valid data were available for the platelet-to-high-density lipoprotein cholesterol ratio, follow-up, and primary-model covariates. Incident stroke was based on questionnaire-reported physician diagnosis without independent confirmation using medical records, neuroimaging, or stroke subtype adjudication. Cox models evaluated the platelet-to-high-density lipoprotein cholesterol ratio continuously and stratified by quartiles. Component, selection-bias, community-cluster robust, spline, and additional-adjustment analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During 34,637.3 person-years of follow-up, 551 participants reported incident stroke. Each 1-SD increase in the platelet-to-high-density lipoprotein cholesterol ratio was associated with a higher stroke hazard in Model 3 (hazard ratio, 1.15; 95% confidence interval, 1.07\u20131.24;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). A comparison of quartile 4 versus quartile 1 data yielded a hazard ratio of 1.33 (95% confidence interval, 1.05\u20131.69;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.018\n                      <jats:italic toggle=\"yes\">; p<\/jats:italic>\n                      for trend\u2009=\u20090.007). Platelet count was positively associated with stroke (hazard ratio per 1-SD increase, 1.16; 95% confidence interval, 1.07\u20131.25), while the inverse high-density lipoprotein cholesterol association attenuated after mutual adjustment. Community-cluster robust inference was similar. Restricted cubic spline analysis revealed an overall association between the platelet-to-high-density lipoprotein cholesterol ratio and hazard of first incident stroke (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.006), with no evidence of departure from linearity (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      for nonlinearity\u2009=\u20090.812).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A higher baseline platelet-to-high-density lipoprotein cholesterol ratio was associated with a higher hazard of first incident stroke among adults who met the criterion for hypertension at baseline and were stroke-free at baseline. The observational design and nonadjudicated outcome preclude causal or clinical-prediction claims; independent validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261496762","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:03:05Z","timestamp":1791514985000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between platelet-to-high-density lipoprotein cholesterol ratio and incident stroke among adults with hypertension: A longitudinal CHARLS cohort study"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8687-8087","authenticated-orcid":false,"given":"Siyi","family":"Jiang","sequence":"first","affiliation":[{"name":"The Fourth Affiliated Hospital, Zhejiang University School of Medicine","place":["China"]},{"name":"Zhejiang University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Cui","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital, Zhejiang University School of Medicine","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengwei","family":"Jia","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital, Zhejiang University School of Medicine","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"The Second Hospital of Shanxi Medical University","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Li","sequence":"additional","affiliation":[{"name":"The Fourth Affiliated Hospital, Zhejiang University School of Medicine","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00369-7"},{"key":"e_1_3_3_3_2","first-page":"505","article-title":"Analysis of stroke burden in China from 1990 to 2021 and projections for the next decade","volume":"59","author":"Zhang T","year":"2025","unstructured":"Zhang T, Li X, Jin T, et al. 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