Hypertension Severity, Race/Ethnicity and Stroke Recurrence Risk among Oldest Old Intracerebral Hemorrhage Survivors

Abstract

Background Oldest old (age ≥80 years) survivors of Intracerebral Hemorrhage (ICH) may be at higher risk for stroke recurrence, reflecting increasing hypertension severity with aging. Because minority ICH survivors (African American and Hispanic) are at higher risk of stroke recurrence, oldest-old individuals in these racial/ethnic groups are likely to be at even higher risk. We sought to determine whether: 1) oldest old ICH survivors are at higher risk for stroke recurrence; and 2) minority oldest-old ICH survivors are at even higher risk for recurrent stroke than age-matched white counterparts. Methods We analyzed data from survivors of primary ICH, enrolled in two prospective studies (the ICH study at Massachusetts General Hospital and the Longitudinal Extension of the ERICH study). Exposures of interest include patients’ demographics (including self-reported race/ethnicity), medical history, ICH characteristics, Blood Pressure (BP) measurements and medications exposures during follow-up. Outcome of interest was recurrent stroke (i.e. ICH and/or ischemic stroke) during follow-up. Results We enrolled 1938 ICH survivors, including 507 aged ≥80 years (435 white, 38 African American, and 34 Hispanic) and 1431 aged Conclusion Oldest old ICH survivors, and specifically minority survivors age ≥80 years, are at higher risk for stroke recurrence and more likely to demonstrate inadequate blood pressure control. Future ICH studies will benefit from focusing on blood pressure control among oldest old survivors, with specific emphasis on African Americans.