DESERVE: Strong social networks reduce vascular risk in stroke, TIA
Patients with stroke who could discuss important matters with multiple family members and friends had a greater mean BP reduction compared with those without a social network structure, according to an abstract presented at the International Stroke Conference.
“It's well known that stroke survivors have various and numerous needs,” Eric T. Roberts, MPH, associate research scientist at the College of Global Public Health at New York University and an NIH Stroke Net Trainee, told Cardiology Today. “We hypothesize that our results demonstrate that network members ‘step up to the plate’ in an emergency situation to care for a friend or family member and that having more network members means the patient is more likely to have the correct kind of social support provided without over-burdening any one network member. Our results also highlight that this support need not come from a family member or a person living in your household, which supports previous findings that patients engage in different health behaviors with different network members.”
Researchers analyzed data from 552 patients who had a stroke or transient ischemic attack. Participants were asked to identify up to five people with whom they discuss important topics with and to detail each relationship.
Network characteristics that were reviewed included having a person in the same household, the number of people, communication frequency, relationship closeness, education level of each person and family-only vs. family and friend networks.
The outcome of interest was the difference in systolic BP from baseline to 12 months.
Sixteen percent of participants had no people with whom they discussed important matters with, 57% identified one or two people and 27% had between three and five people.
Of the group with at least one person, 73% of participants reported having a family-only network and 59% reported having a person within the same household.
Of those reporting between three and five network members, 28% talked to fewer than three of them at least several days per week, 22% were very likely to discuss health concerns with fewer than three of them, 21% had an extremely or very close relationship with fewer than three of them, and 50% had fewer than three network members with more than a high school education.
After adjusting for age, trial arm, race-ethnicity, sex and education, having three to five people vs. zero (beta = 10.86; P = .01), having people beyond a family-only network (beta = 6.11; P = .03) and having three to five network members with at least three having more than a high school education (beta = 14.12; P < .01) were linked to a greater mean BP reduction. Having at least three network members was significantly associated with a greater mean BP reduction irrespective of how frequently the network members communicated (3-5, 3+ frequently beta = 9.00; P = .03; 3-5, < 3 frequently beta = 15.72; P < .01), how likely they were to discuss health matters (3-5, 3+ very likely beta = 9.85; P = .01; 3-5, < 3 frequently beta = 14.51; P = .01), or how close their relationship were (3-5, 3+ very/extremely close beta = 10.21; P = .01; 3-5, < 3 very/extremely close beta = 13.54; P = .02).
“We are proposing to investigate our hypothesis in the framework of a clinical trial to assess whether actively involving network members in [a randomized controlled trial] improves both secondary prevention for the patient and primary prevention for the network members,” Roberts told Cardiology Today. – by Darlene Dobkowski
Roberts ET, et al. Abstract 185. Presented at: International Stroke Conference; Jan. 23-26, 2018; Los Angeles.
Disclosure: Roberts reports no relevant financial disclosures.