Abstract WP521: Health Beliefs and Blood Pressure Reduction in the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) Study

Abstract

Introduction: Hypertension is a leading risk factor for stroke recurrence. Previous studies have found that patients’ health attitudes and beliefs play a critical role in shaping health behaviors. The aim of this analysis is to investigate the relationship between specific health beliefs and blood pressure reduction following stroke. Methods: DESERVE is an RCT of a skills-based educational intervention vs. standard care in a multi-ethnic cohort of mild/moderate stroke and TIA survivors. The relationship between participants’ baseline health beliefs and systolic blood pressure (SBP) reduction from baseline to one-year follow-up was assessed. Health beliefs were measured by asking participants to agree or disagree with five health belief questions such as, ‘I worry about having a stroke,’ ‘I can protect myself against having a stroke,’ and ‘Some people are more likely to have a stroke than others.’ Multivariable linear regression models were used to assess the relationship between each health belief and SBP reduction. Results: A total of 434 patients were included in the analysis (50.2% female; mean age 64.2; 29.7% non-Hispanic white, 32.0% non-Hispanic black, 32.5% Hispanic, 5.8% other). Of those participants, 77.9% agreed with the statement, “I can protect myself against having a stroke” and had a significantly greater mean SBP reduction compared to those who disagreed (6.29 vs. 1.57 mmHg, p=0.02). No other health belief questions were found to be significantly associated with SBP reduction. In the multivariable model, adjusting for age, gender, race, education, intervention status, stroke history, and marital status, agreeing that you can protect yourself against having a stroke was associated with a 6.44 mmHg greater mean SBP reduction compared to disagreeing (p=0.02). Conclusion: In this cohort of stroke/TIA patients, participants who agreed that they could protect themselves against having a stroke had an average mean SBP reduction of more than two times that of participants who disagreed with that statement. Certain health beliefs, such as those related to patient empowerment, may play an important role in secondary stroke prevention.