Stroke Risk Factor Status and Use of Stroke Prevention Medications Among Hispanic/Latino Adults in HCHS/SOL

Author:

Bai Fang1,Chen Jingsong2,Pandey Dilip1ORCID,Durazo-Arvizu Ramon2ORCID,Talavera Gregory A.3,Allison Matthew A.4,Perreira Krista M.5,Schneiderman Neil6,Sutherland Melanie W.7,Cai Jianwen5,Daviglus Martha L.2ORCID,Testai Fernando D.1ORCID

Affiliation:

1. Department of Neurology and Rehabilitation (F.B., D.P., F.D.T.), University of Illinois at Chicago.

2. Institute for Minority Health Research (J.C., R.D.-A., M.L.D.), University of Illinois at Chicago.

3. Graduate School of Public Health, San Diego State University, CA (G.A.T.).

4. Department of Family and Preventive Medicine, University of California, San Diego, La Jolla (M.A.A.).

5. Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill (K.M.P., J.C.).

6. Department of Psychology, Behavioral Medicine Research Center, University of Miami, FL (N.S.).

7. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia (M.W.S.).

Abstract

Background and Purpose: We investigated the prevalence, awareness, and control of vascular risk factors (VRFs) and the use of antithrombotic and statin agents in HCHS (Hispanic Community Health Study)/SOL (Study of Latinos) participants with self-reported history of stroke or transient ischemic attack. Methods: Sociodemographic characteristics, medications, and prevalence of different VRFs were recorded. VRF diagnoses and goals were based on the recommendations of professional organizations. Factors associated with optimal VRF control and use of antithrombotic and statin agents were investigated using multivariate logistic regression. Results: The analysis included 404 participants (39% men). The prevalences of hypertension, dyslipidemia, and diabetes were 59%, 65%, and 39%, respectively. Among those who met the diagnostic criteria for these diagnoses, the frequencies of awareness were 90%, 75%, and 83%, respectively. In participants who were aware of their VRFs, the prevalences of controlled hypertension, dyslipidemia, and diabetes were 46%, 32%, and 54%. Approximately 46% of the participants were on antithrombotics, 39% on statins, and 26% on both. Only 38% of those with atrial fibrillation received anticoagulation. In multivariate analyses adjusted for baseline sociodemographic characteristics, older age was associated with uncontrolled hypertension and diabetes. Residing in the United States for ≥10 years and born in the United States were associated with uncontrolled diabetes, female sex with uncontrolled dyslipidemia, and lack of health insurance with decreased use of statins and hyperlipidemia. Conclusions: Hispanic/Latino adults in the United States have high prevalence and awareness of VRFs but low adherence to secondary stroke prevention strategies. Older adults, women, and uninsured people are vulnerable groups that may benefit from targeted interventions. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02060344.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

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