Abstract 192: Gender and Racial Disparities in Secondary Prevention of Stroke

Abstract

Introduction: In the US, 795 000 people suffer a stroke and 133 000 die from it annually. Among the survivors, 185 000 get a recurrent stroke. There are gender and racial disparities in stroke mortality and there is need to understand the associated factors, if the AHA’s 2020 impact goal is to be achieved. The objective of this study was to assess the gender and racial differences in the use of secondary preventive measures in patients with stroke, and to identify the associated factors. Methods: This is an analysis of the 2015 Behavioral Risk Factor Surveillance System, a chronic disease survey conducted by the CDC. The sample included 18 269 subjects with stroke. outcomes analyzed included: exercise, diet, smoking cessation, alcohol intake, body mass index, use of blood pressure (BP) medications and the use of aspirin. Gender and racial disparities were analyzed using logistic regression analysis. Age, race, education and income were adjusted for in the outcomes. Results: Women comprised 58.3% of the stroke cohort. White, black and Hispanic respondents represented 75.1%, 11.5% and 4.7% respectively. The mean ages of study subjects were 66.6 and 67 years for men and women respectively. Women were more likely to continue smoking (OR 1.22 (1.13, 1.32)), less likely to meet both the AHA exercise guidelines (OR 0.87 (0.81, 0.94)) and more likely to be obese/overweight (OR 1.45 (1.35, 1.54)). They were also less likely to be on aspirin (OR 0.57 (0.40, 0.80)) and BP medications (OR 0.96 (0.85, 1.09)). Women were more likely to eat ≥1 servings of fruits (OR 1.41 (1.33, 1.50)) and vegetables (OR 1.32 (1.23, 1.40)), were more likely to have health insurance (OR 1.21 (1.04, 1.40)) and clinical provider (OR 1.76 (1.75, 1.76)). Hispanics were more likely to continue smoking compared with whites (OR 1.37 (1.15, 1.63), Blacks and Hispanics were less likely to exercise compared with whites (OR 0.66 (0.61, 0.72) and (OR 0.78 (0.68, 0.88) respectively. Blacks were less likely to eat fruits (OR 0.7 (0.64, 0.76) and vegetables (OR 0.56 (0.51, 0.61) but these effects were attenuated by adjusting for income and education. Conclusion: There are significant gender and racial disparities in secondary stroke preventive measures. Income and education may play an important role in the disparity.