Abstract WMP104: Influence of Living Arrangements and Within Household Communications on Blood Pressure Control Among Stroke Patients

Abstract

Introduction: Social support plays a vital role in shaping health behaviors and may impact disease outcomes such as blood pressure (BP) control. We aim to study the association between household living arrangements and BP control for stroke patients, over time and by household communication type. Methods: Discharge Educational Strategies for Reduction of Vascular Events (DESERVE), which aimed to improve post-stroke BP, randomized stroke survivors to skills-based intervention or usual care. Baseline, 6- and 12-month BP was measured according to AHA guidelines with BP control defined as no hypertension present or if follow-up BP was within normal range. We grouped baseline household arrangements as nuclear, multigeneration, spouse, alone, or other and household communication as engaging in conversations about stroke or not. We estimated adjusted odds of BP control by living arrangements and within household communication controlled for age, gender, race/ethnicity, education, Medicaid, and intervention status. Results: Among 540 participants with baseline BP data (72% with hypertension), 361 and 478 had 6- and 12-month data, respectively. Most patients lived in nuclear households (31%), followed by living alone (25%). About 36% participants achieved well-controlled BP after 6 months, increasing to 37% after 12 months. Living in a nuclear arrangement was associated with 2.59 (95% CI: 1.13-5.94) times higher odds of BP control at 6 months. Among participants with multigenerational families, those engaged in conversations about stroke within household showed 5.52 (1.25-24.3) times higher odds of BP control at 12 months. Conclusions: Our findings suggest that living arrangements are positively related to BP control outcomes in stroke patients, and communication with household members on health topics modifies this association. Within household social support to stroke patients may offer an opportunity for targeted secondary stroke prevention strategies.