Journal of International Medical Research · Published 2026-07-01 · DOI 10.1177/03000605261459294
Mingyue Ding, Bingyu Qin
Objective To investigate the association between the high-sensitivity C-reactive protein-to-hemoglobin ratio and stroke risk among middle-aged and older adults. Methods A prospective follow-up study was conducted using cohort data from the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study of Ageing (ELSA). Participants without a history of stroke at baseline were included, comprising 5368 individuals from CHARLS and 1422 from ELSA. Cox proportional hazards regression models were used to analyze the association between C-reactive protein-to-hemoglobin ratio levels and stroke risk, along with dose–response analyses and subgroup interaction testing. Results After adjusting for sex, age, lifestyle factors, and multiple clinical biochemical indicators, the participants in Q2, Q3, and Q4 demonstrated a significantly higher risk of stroke than those in Q1 (reference group). The hazard ratios were 2.23 (1.35–3.69), 2.24 (1.36–3.71), and 3.14 (1.93–5.12), respectively (all P < 0.01). Dose–response analysis revealed an approximately linear positive association between C-reactive protein-to-hemoglobin ratio and stroke risk. Conclusions C-reactive protein-to-hemoglobin ratio levels are significantly and positively associated with stroke risk in middle-aged and older adults.
Abstract from DOAJ. Public domain (CC0 1.0).
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Ding, M., Qin, B. (2026). Association of high-sensitivity C-reactive protein-to-hemoglobin ratio with stroke risk: A study based on the China Health and Retirement Longitudinal Study and English Longitudinal Study of Ageing cohorts. Journal of International Medical Research. https://doi.org/10.1177/03000605261459294