Abstract TP115: Racial/ethnic Differences In Subacute Blood Pressure Trajectories Following Intracerebral Hemorrhage

Abstract

Introduction: Existing observational evidence indicates that blood pressure (BP) differs by race/ethnicity in the first 24 hours after spontaneous intracerebral hemorrhage (ICH). However, differences in BP across race/ethnic groups beyond this acute period remain understudied. Hypothesis: Race/ethnic differences in BP levels and variability persist after the initial 24 hours. Methods: We analyzed data from the Yale Longitudinal Study for Acute Brain Injury, an ongoing observational study that longitudinally follows adult (>18 years) patients admitted to the neurocritical care and stroke services of the Yale Health System. For this study, we included patients with ICH enrolled between January 2018 and January 2022 and abstracted from the Electronic Health Record BP measurements obtained during the first 7 days of admission. Mean systolic BP was calculated in 4-hour epochs. Blood pressure variability was calculated as the trough of systolic blood pressures. Multivariable linear regression models were used to analyze differences in systolic BP and BP variability across race/ethnic groups. Results: A total of 738 patients (mean age 68, 45% female) were included in the study, including 530 (71.8%) whites, 138 (18.7%) African Americans, and 70 (9.5%) Hispanics. African Americans had trend toward statistically higher systolic BP (beta 2.7, SE 1.49; p= 0.06) as well as higher BP variability than whites (beta 2.34, SE 1.16; p= 0.045) and Hispanics (beta -0.61, SE 1.50; p=0.68). Other factors associated with systolic BP were age (beta 0.17, SE 0.04; p<0.001) and history of hypertension (beta 8.42, SE 1.47; p<0.001). Similarly, age (beta 0.11, SE 0.03; p<0.001) and history of hypertension (beta 3.16, SE 1.15; p<0.001) were also significantly associated with BP variability. Conclusions: Among patients with ICH admitted to a single health care system study of acute brain injury, Black race was associated with higher BP variability and, possibly, higher systolic BP. Given the pivotal role of BP management in the care of patients with ICH, further research is needed to understand how the observed differences could translate into race/ethnic-specific strategies to manage BP.