Risk factor control poor among Hispanic, Latino patients with prior stroke, TIA
The prevalence of hypertension, dyslipidemia and diabetes among Hispanic and Latino adults with prior stroke or transient ischemic attack is high, and control of these risk factors is poor, researchers reported.
According to data published in Stroke, fewer than half of Hispanic and Latino patients with these vascular risk factors and prior stroke or TIA were on antithrombotic or statin therapies.
“It’s a wake-up call for the medical community. Despite our best efforts, Hispanic and Latino populations still seem to be undertreated for their vascular risk factors,” Fernando D. Testai, MD, PhD, FAHA, associate professor of neurology at the University of Illinois at Chicago, said in a press release. “I didn’t expect the numbers to be so dismal. We found many of the participants with previous stroke knew about their vascular risk factors; however, the data indicate they are receiving inadequate treatment and support, which are a real concern.”
For this analysis, researchers included 404 participants from the Hispanic Community Health Study/Study of Latinos (mean age, 55 years; 39% men; 51% with obesity; 22% current smokers) to evaluate the prevalence, awareness and control of vascular risk factors and the use of antithrombotic and statin therapies among patients with a self-reported history of stroke or TIA.
Risk factor prevalence, control
Overall, the prevalence and control of vascular risk factors were as follows:
- The prevalence of hypertension was 59% and control was 46%.
- The prevalence of dyslipidemia was 65% and control was 32%.
- The prevalence of diabetes was 39% and control was 54%.
Researchers observed that 46% of participants were on an antithrombotic therapy, 39% were on statin therapy and 26% were on both.
Additionally, only 38% of participants with atrial fibrillation were on an anticoagulant.
Multivariate subgroup analysis
Researchers found that older age was associated with poorer control of hypertension (adjusted OR = 0.95; 95% CI, 0.92-0.97) and diabetes (aOR = 0.96; 95% CI, 0.93-0.99); however, older adults more frequently used antithrombotic (aOR = 1.06; 95% CI, 1.03-1.08) and statin therapies (aOR = 1.08; 95% CI, 1.05-1.11) compared with younger adults.
Women were more likely to have uncontrolled dyslipidemia compared with men (aOR = 0.49; 95% CI, 0.28-0.86), according to the study.
Lack of health insurance was associated with reduced odds of dyslipidemia control (aOR = 0.42; 95% CI, 0.18-0.95) and statin use (aOR = 0.47; 95% CI, 0.23-0.97).
Moreover, odds of optimal diabetes control were decreased among participants who preferred to speak English (aOR = 0.25; 95% CI, 0.12-0.55), immigrants who resided in the U.S. for more than 10 years (aOR = 0.06; 95% CI, 0.01-0.32) and those born in the U.S. (aOR = 0.03; 95% CI, 0-0.24).
“Health care professionals can help inform and support Hispanic/Latino adults about the importance of adopting healthy lifestyle behaviors in order to reduce cardiovascular risk,” Testai said in the release. “Almost 80% of people in this study were overweight or obese, and a significant number continued to smoke despite having a history of stroke and other cardiovascular events. Access to care is another important area that we need to address to reduce cardiovascular risk in this population.”