## 4 Discussion
In that study, abdominal fat mass was the best indicator of stroke in women (HR = 1.66, CI [1.23-2.24]). Notably, after adjustment for BMI, the associations remained significant in both women (HR = 1.80, CI [1.06-3.07]) and men (HR = 1.71, CI [1.13-2.59]); however, abdominal fat was not retained as a significant factor after adjusting for diabetes, smoking, and hypertension, resulting in the identification of abdominal fat mass as the best predictor in women [26]. In a different study, BMD was associated as an independent risk factor with stroke in 4302 men and women aged 40-75 years through the analysis of HR and CI values [27]. Specifically, femoral neck BMD (HR = 1.23, CI = 1.01-1.49) was found to constitute an independent predictor of stroke following adjustment for age, sex, and BMI. Moreover, decreased BMD and osteoporosis of the femoral neck were independently associated with stroke and death [27]. Finally, evaluation of the association of stroke with low BMD in 63 patients with stroke and 188 normal subjects, including men and women aged over 60 years, identified that femoral neck BMD (\(p\) = 0.007) was 8% lower than that of female control participants. The significance of these results was maintained after adjustment for BMI, alcohol consumption, previous MI, and medication for hypertension. However, the association of stroke with BMD was not observed in men [28]. Considerable evidence supports the relationship between hypertension and stroke. Evaluation of morning hypertension and stroke in 519 elderly individuals with monitored ambulatory BP identified morning SBP (RR = 1.44) as exhibiting the strongest association with stroke; the differences between morning and evening SBP were also associated (RR = 1.24), highlighting hypertension as the strongestrisk factor of stroke [10]. Nevertheless, an analysis of the relationship between prehypertension; hypertension; and CVD, including ABI, stroke, MI, and CAD found that prehypertension was associated with MI (RR = 3.5, CI [1.6-7.5]) and CAD (RR = 1.7, CI [1.2-2.4]) but not ABI (RR = 2.2, CI [0.5-9.3]), thus indicating a lack of relationship between early disease and stroke [12]. In contrast, untreated hypertension was identified as a highly prevalent and important risk factor for stroke, as shown using data collected by screening all area hospitals, emergency rooms, radiology reports, and International Classification of Diseases 9 codes in the greater Cincinnati region [8]. Specifically, untreated hypertension was a significant risk factor for hemorrhagic stroke (\(p\) < 0.0001, OR = 3.5 [2.3-5.2]) [8]. In turn, a study of the association of BP with acute stroke, in which data were analyzed as OR, weighted mean differences and CI using Cochrane Review Manager software, identified significant association of mean arterial BP (OR = 1.61 [1.12-2.31]), DBP (OR = 1.71 [1.33-2.48]), and SBP (OR = 2.69 [1.13-6.40]) with ischemic stroke or death, suggesting that decreasing BP might improve the outcome of stroke treatments [11]. Finally, evaluation of data from patients with first-ever stroke identified from a community-based stroke registry in 1994-95 in northwest England, including 267 stroke cases and 534 control subjects, showed a stroke OR of 2.6 after adjusting for hypertension along with a 6-fold increased stroke risk (OR = 6.1 [2.7-13.7]) in patients with hypertension who were smokers [9]. Furthermore, patients with a preexisting history of MI, obesity, or diabetes exhibited 3-fold increased stroke risk, with the risk steadily increased in patients with hypertension [9]. Together, these results confirm hypertension as an important risk factor for stroke. Various studies have been conducted to predict and identify CVD, coronary heart disease, vascular disease, hypertension, and stroke using machine learning, data mining, and AI techniques [33-35]. [PERSON] et al.