Abstract T MP90: Effect of Race and Early Blood Pressure Control on Long-Term Blood Pressure Control and Recurrent Stroke Risk
Background: Many studies have documented racial disparities in blood pressure (BP) control. However, little is known about how race and short-term BP control affect hypertension control in the long-term and recurrent stroke risk.
Methods: We utilized data on patients with ischemic stroke included in a randomized quality improvement trial focused on secondary stroke prevention, conducted in 14 Kaiser Permanente hospitals in Northern California 01/2004-09/2006 (QUISP). Patient characteristics, diagnoses, health care utilization, BP measurements and medications were gathered from administrative and clinical databases. We used multivariable logistic regression to examine race and 6-month BP control (<140/90 mmHg) as predictors of BP control and stroke recurrence at 1 and 5 years after index event among patients, adjusted for socio-economic status, age, gender, and risk factors, and dementia.
Results: There were 2971 patients in the initial cohort including 66% non-Hispanic white, 14% Blacks, 11% Asian, 8% Hispanic, and 1% other. BP was controlled in 74% of cohort at 1 year, and 80% at 5 years (Table). Having BP control at 6 months post-stroke was associated with having BP control both at 1 year (OR=2.33, 95% CI 1.83-2.96, p<0.001) and 5 years (OR=1.98, 95% CI 1.45-2.68, p<0.001) follow-up. Blacks (OR=0.71, 95% CI 0.51-0.98, p=0.04) were less likely to have BP controlled at 1 year compared to whites. Blacks had an increased risk of recurrent stroke at 1 year (OR=1.70, 95% CI 1.07-2.70, p=0.02) post index event.
Conclusion: Early BP control was associated with long-term BP control. Despite having equal healthcare utilization, and antihypertensive prescriptions, blacks had poorer long-term BP control and higher recurrent stroke risk compared to whites. Greater efforts in reducing racial disparities in early hypertension control after stroke are needed.
Author Disclosures: M.N. Nguyen-Huynh: None. L. Tucker: None. J. Klingman: None. J.D. Young: None. S. Sidney: None.
- © 2014 by American Heart Association, Inc.