Association between body roundness index and incident stroke with different blood pressure status: A retrospective propensity score matched analysis of the CHARLS study.

Higher BRI was significantly associated with increased stroke risk in the overall CHARLS cohort after propensity score matching.

• Sample comprised 12,316 CHARLS participants aged ≥45 years without prior stroke
• Following PSM, fully adjusted models indicated that a unit rise in log(BRI) was tied to a 19% increase in stroke risk (HR = 1.79, 95% CI: 1.37–2.34, P < 0.001)
• Cox proportional hazards models were used to evaluate the association between BRI and incident stroke
• Additional analyses included propensity score matching, subgroup analyses, and sensitivity tests to strengthen validity

The association between BRI and stroke risk was most pronounced among individuals with prehypertension.

• Among prehypertensive individuals, a unit rise in log(BRI) was associated with HR = 2.60 (95% CI: 1.49–4.54; P < 0.001)
• This was the strongest association observed across all blood pressure strata
• Analysis was performed following propensity score matching with full covariate adjustment

BRI was significantly associated with stroke risk among individuals with hypertension.

• Among hypertensive individuals, the association yielded HR = 1.65 (95% CI: 1.17–2.33; P = 0.004)
• The association was statistically significant following PSM and full covariate adjustment
• The effect size was smaller than that observed in the prehypertension subgroup

No statistically significant association between BRI and stroke risk was observed among participants with normal blood pressure following PSM.

• After stratification by blood pressure status, the normal blood pressure subgroup did not show a significant BRI–stroke association following PSM
• This contrasted with findings in the prehypertension and hypertension subgroups
• Subgroup and sensitivity analyses supported the reliability of this null finding in the normal blood pressure group

ROC analysis demonstrated that BRI had moderate predictive accuracy for stroke, with notable performance in individuals with normal blood pressure.

• The area under the curve (AUC) for BRI predicting stroke in individuals with normal blood pressure was 0.672
• ROC analysis was used to assess the discriminative capacity of BRI for predicting stroke events
• BRI is described as an innovative anthropometric measure assessing visceral fat that has demonstrated utility in predicting cardiometabolic risk