Sex, race gap in secondary stroke prevention attributed to income, education

Income and education play a role in significant sex and racial disparities in secondary stroke preventive measures, according to data presented at the International Stroke Conference.

Paul M. Ndunda, MD, and Tabitha M. Muutu, MD, of the department of internal medicine at the University of Kansas School of Medicine, sought to study the sex and racial differences in the use of secondary preventive measures in patients with stroke and identify associated factors by analyzing data from the 2015 Behavioral Risk Factor Surveillance System composed of 18,269 patients (mean age, 67 years; 58% women, 75% white) with stroke. Outcomes analyzed included exercise, diet, smoking cessation, BMI, BP medication use and alcohol intake.

“In the U.S., 795,000 people suffer a stroke and 133,000 die from it annually. Among the survivors, 185,000 get a recurrent stroke,” the researchers wrote in an abstract. “There are gender and racial disparities in stroke mortality, and there is need to understand the associated factors if the [American Heart Association]’s 2020 impact goal is to be achieved.”

Women were more likely to continue smoking (OR = 1.22; 95% CI. 1.13-1.32) and less likely to meet AHA exercise guidelines (OR = 0.87; 95% CI, 0.81-0.94). Women were also more likely to be obese or overweight (OR = 1.45; 95% CI, 1.35-1.54) and less likely to be on aspirin (OR = 0.57; 95% CI, 0.4-0.8) or BP medications (OR = 0.96; 95% CI, 0.85-1.09), Ndunda and Muutu reported.

Women were like likely to eat one or more servings of fruits (OR = 1.41; 95% CI, 1.33-1.5) and vegetables (OR = 1.32; 95% CI, 1.23-1.4) and were more likely to have medical insurance (OR = 1.21; 95% CI, 1.04-1.4) and a clinical provider (OR = 1.76; 95% CI, 1.75-1.76), the researchers wrote.

Hispanics were more likely to continue smoking compared with white patients (OR = 1.37; 95% CI, 1.15-1.63), whereas black (OR = 0.66; 95% CI, 0.61-0.72) and Hispanic patients (OR = 0.78; 95% CI, 0.68-0.88) were less likely to exercise compared with white patients, according to the data.

Black patients were less likely to eat fruits (OR = 0.7; 95% CI, 0.64-0.76) and vegetables (OR = 0.56, 95% CI, 0.51-0.61), but the effects were lessened by adjusting for income and education, the researchers wrote. – by Earl Holland Jr.

Reference:

Ndunda PM, et al. Abstract 192. Presented at: International Stroke Conference; Feb. 6-8, 2109; Honolulu.

Disclosures: The authors report no relevant financial disclosures.