Abstract P238: Stroke-belt Residence And Post-stroke Statin Use

Abstract

Background: AHA/ASA guidelines recommend statins in appropriate patients to reduce the risk of recurrent stroke. Previous studies have found disproportionately high stroke readmission rates in the Stroke Belt (SB) region in the southern portion of the United States. There is limited information about contemporary post-stroke statin use in SB residents and how this compares to other regions of the country. Methods: Stroke patients residing in or outside the SB who had a history of hyperlipidemia were identified from the nationally representative 2017 and 2019 Behavioral Risk Factor Surveillance System surveys. Current statin use (Yes/No) was ascertained. Survey-weighted estimates of overall and sex- and age-specific statin use were determined by SB resident status. Logistic regression with survey weighting was applied to calculate odds ratios of statin use without and with adjustment for stroke-related sociodemographic covariates. Results: The sample included 21,006 stroke survivors (16% SB residents). SB residence (80.8% vs. 78.9% in non-SB residents, Figure) was not associated with higher odds of post-stroke statin use without or with confounder adjustment. In sex- and age-specific analyses, SB residents were more likely than non-SB residents to use statins following a stroke in all subgroups, with this difference being most pronounced in those age 18-44y. Conclusions: Overall statin use was similar between stroke survivors residing in SB and non-SB states but was lowest among those aged 18-44 years regardless of residence. Our findings suggest other factors related to post-discharge care may more greatly impact recurrent stroke rates in rural US areas than statin medication use and warrant additional study.