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RRP 07-293 – HSR&D Study

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RRP 07-293
Racial Disparities in Blood Pressure Management Among Stroke Patients
Dawn M. Bravata MD
Richard L. Roudebush VA Medical Center, Indianapolis, IN
Indianapolis, IN
Funding Period: August 2007 - February 2008

BACKGROUND/RATIONALE:
Hypertension is a common modifiable risk factor for stroke. A large body of evidence demonstrates that lowering blood pressure reduces stroke risk substantially. Disparities in stroke risk factors, particularly in the control of hypertension, have been demonstrated in the non-VA setting.

OBJECTIVE(S):
The objectives were to examine whether racial differences exist in the management of blood pressure within Department of Veterans Affairs (VA) hospitals: (1) in the one-year prior to hospitalization for acute ischemic stroke, (2) at the time of discharge from the hospital, and (3) in the one year after discharge from the stroke hospitalization.

METHODS:
Medical records of patients admitted with an ischemic stroke to one of three VA medical centers were reviewed. The primary outcome was the proportion of patients with blood pressure at goal (defined as <140/90 mm Hg or <130/80 mm Hg in the setting of diabetes or renal insufficiency) at three time points: pre-stroke, at hospital discharge, and post-stroke.

FINDINGS/RESULTS:
Data were available for: 90 patients pre-stroke, 107 patients at that time of discharge, and 87 patients post-stroke. In the pre-stroke period, 9/17 (52.9%) Blacks had blood pressure at goal compared with 35/73 (48.0%) Whites (p=0.79). At the time of discharge from the hospital, 6/17 (35.3%) Blacks compared with 43/90 (47.8%) Whites had blood pressure at goal (p=0.43). One year after discharge from the stroke hospitalization, 8/14 (57.1%) Blacks compared with 40/73 (54.8%) Whites had blood pressure at goal (p=1.0)


IMPACT:
These data suggest that there are no statistical differences in blood pressure control between Blacks and Whites within the VA system.

PUBLICATIONS:
None at this time.


DRA: none
DRE: Prevention
Keywords: Ethnic/cultural, Hypertension, Stroke
MeSH Terms: none

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