Abstract Details

Title Vascular Risk Factor Prevalence and Trends in Native Americans with Ischemic Stroke

Topic Health Care Disparities

Presentation(s) Health Care Disparities Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 007

Background

Native Americans have a higher incidence and prevalence of stroke and the highest stroke-related mortality among race-ethnic groups in the United States. There is a paucity of data detailing recent trends in risk factor burden in this race-ethnic group.

Objective To analyze vascular risk factor prevalence and trends among Native Americans with ischemic stroke (IS).

Design/Methods National Inpatient Sample (NIS) database was used to explore the prevalence of risk factors among hospitalized IS patients during 2000 - 2016. Linear trends were explored using linear regression models, with differences in trends between the Native American group and the other race-ethnic groups assessed using interaction terms. The analysis accounted for the complex sampling design, including hospital clusters, NIS stratum, and trend weights for analyzing multiple years of NIS data.

Results

Native Americans constituted 5472 of the 1,278,784 IS patients. The age-and-sex-standardized prevalence of hypertension (slope = 2.24, p < 0.001), hyperlipidemia (slope = 6.29, p < 0.001), diabetes (slope = 2.04, p = 0.005), atrial fibrillation/flutter (trend slope = 0.80, p = 0.011), heart failure (trend slope = 0.73, p = 0.036) smoking (trend slope = 3.65, p < 0.001), and alcohol (slope = 0.60, p = 0.019) increased among Native Americans, except for coronary artery disease. Native Americans showed larger increases in hypertension prevalence compared to Blacks, Hispanics, and Asian/Pacific Islanders and in smoking prevalence compared to Hispanics and Asian/Pacific Islanders. By the year 2015-2016, Native Americans had the highest overall prevalence of diabetes, coronary artery disease, smoking, and alcohol among all race-ethnic groups.

Conclusions The prevalence of most vascular risk factors among Native American ischemic stroke patients has increased in the last two decades. Significantly larger increases in hypertension and smoking were seen in Native Americans compared to other race-ethnic groups along with them having the highest prevalence in multiple risk factors in recent years.

Authors/Disclosures
Dinesh V. Jillella, MD (Emory University School of Medicine / Grady Memorial Hospital) PRESENTER	Dr. Jillella has nothing to disclose.
	No disclosure on file
	No disclosure on file
Atif Zafar, MD (St. Michael's Hospital (University of Toronto))	Dr. Zafar has nothing to disclose.
	No disclosure on file
Ken Uchino, MD (Cleveland Clinic Foundation)	Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aboott Laboratories, Inc.. Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACP JOURNAL CLUB. The institution of Dr. Uchino has received research support from NIH.