Abstract TMP95: Patients With Stroke Are Not Meeting American Heart Association Secondary Prevention Recommendations

Abstract

Introduction: Stroke occurs in 795 000 people and causes 133 000 deaths every year in the US. Around 185 000 stroke survivors get recurrent attacks annually. There is a need to understand the adherence to secondary prevention measures if the AHA’s 2020 impact goal is to be achieved. Atherosclerotic cardiovascular disease risk factors remain prevalent in the US but there is limited data on the use of secondary preventive measures among patients with stroke. The objective of this study was to assess the use of secondary preventive measures in patients with stroke and assess for any gender and racial disparities in adherence. Methods: This study 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 a history of stroke. The secondary preventive measures analyzed included: exercise, diet, smoking cessation, alcohol intake, body mass index, use of blood pressure medications in hypertensives and the use of aspirin. Gender and racial disparities were analyzed using logistic regression analysis and age, race, education, and income were adjusted for in the outcomes. Results: The mean age of the study cohort was 66.8 years (SD =12.1). White, black and Hispanic patients represented 75.1%, 11.5% and 4.7% respectively. Females comprised 58.3%. Comorbidities included: hypertension (73.4%), coronary heart disease (37.5%), dyslipidemia (35.7%), diabetes mellitus (30.4%) and chronic kidney disease (11.6%). Among stroke patients, 57.9% reported ever smoking and 42% of them still smoked. Only 11.3% met both the AHA aerobic and muscle strengthening exercise guidelines. Thirty six percent of stroke patients undertook more than 150 minutes of aerobic exercise and 12% did 1-149 minutes per week. Obesity/overweight was present in 69.9%. Only 59% of patients with stroke were using aspirin while among hypertensive patients, 90.7% took their blood pressure medications. There were major racial and gender disparities in smoking status, obesity, diet, BMI and use of BP medications and aspirin. Conclusion: Patients with stroke do not meet AHA lifestyle modification and aspirin recommendations. There are major gender and racial disparities in the use of stroke secondary preventive measures.