Abstract WP189: Ethnic And Racial Disparities In Prevalent Stroke Among Patients With Heart Failure

Abstract

Background: Ethnic and racial disparities in healthcare contribute to cardiovascular morbidity and mortality. Stroke is prevalent among patients with heart failure (HF) and is associated with worse long-term outcomes. We hypothesized that disparities in cardiovascular risk profiles contribute to differences in stroke prevalence among patients with HF. Methods: We performed a cross-sectional analysis of study participants age ≥ 60 in the biannual NHANES survey. Medical history and clinical variables were obtained from cycles 1999, 2001, 2011, and 2013. We created survey-weighted regression models to generate nationally representative estimates. Results: A total of 20,315 study participants representing 212,156,242 adults were included, 2.5% with prevalent HF. Compared to those without HF, participants with HF were more often of White race (72.8% vs 68.3%, P = 0.02) and less often of Hispanic ethnicity (10.4% vs 14.3%, P = 0.04). Stroke was 10 times more prevalent among individuals with HF (20% vs 2%, P <0.001). In the general population, after controlling for risk factors, Black race was associated with higher risk of stroke (OR: 1.44; 95% CI: 1.16-1.78). There was a significant interaction between HF and race/ethnicity on prevalent stroke (P = 0.05) such that the odds of stroke with HF was significantly higher in individuals of Hispanic ethnicity (OR: 11.9; 95% CI: 4.94-28.6), but similar in White and Black participants. In the assessment of differential risk factor burden among individuals with HF, only rates of diabetes differed between Hispanic and White individuals (36.2% vs 25.5%, p=0.04). There was no difference in mean values of LDL, BMI, systolic blood pressures or prevalent smoking. Conclusion: People of Hispanic ethnicity with HF have a higher prevalence of stroke which is not explained by vascular risk profiles and warrants further investigation.