Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA; Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Dallas, TX, USA; Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, USA.
Department of Neurology and Institute for Stroke and Cerebrovascular Disease, McGovern Medical School at UTHealth, Houston, TX, USA.
J Natl Med Assoc. 2019 Jun;111(3):281-284. doi: 10.1016/j.jnma.2018.10.013. Epub 2018 Nov 12.
Women minorities have an overall increased lifetime incidence of cerebrovascular disease. The provision of risk factor modification in this group can prove difficult. In a population-based study, we used cluster enrollment to identify vascular risk factors in the female caregivers of stroke survivor study participants.
Obese women caregivers were identified as part of Swipe out Stroke, a Phase I PROBE study assessing the use of SmartPhone based intervention for dietary modification in minority stroke survivors. After written informed consent was obtained, both patients and caregivers were screened for vascular risk factors at study enrollment. Descriptive statistics were used to depict the study population. Continuous baseline variables were compared using 2 sample t-test or Wilcoxon rank-sum test by caregivers and patients. Categorical baseline variables were compared using Fisher's exact test.
Thirty-six stroke patients (63.9% African-American, 36.1% Hispanic) and thirteen female caregivers (69.2% African-American, 30.8% Hispanic) were enrolled. Mean age, patients - 54.1 (SD 9.4), caregivers - 51.3 (SD 15.6) years, education, employment status and family history of stroke or obesity did not differ significantly. Compared to stroke patients, female caregivers were significantly less likely to self-report hypertension (69.2 versus 97.2%; P = 0.01) and hyperlipidemia (16.7 versus 60%; P = 0.02). Female caregivers were more likely to have elevated systolic blood pressure (147.6 vs 127.7 mmHg; P = 0.05), total cholesterol (207.5 versus 167 mg/dL; P = 0.01) and low density lipoprotein values (119.5 versus 88 mg/dL; P = 0.03) compared to stroke patients.
Using cluster enrollment, we discovered minority female caregivers were more likely to have unknown or poorly controlled vascular risk factors compared to stroke patients. Innovative health screening tools may benefit the extended family of minority patients participating in clinical trials.
女性少数民族的终生脑血管疾病发病率总体增加。在这一群体中提供危险因素改变可能会很困难。在一项基于人群的研究中，我们使用聚类招募来确定女性卒中幸存者研究参与者的卒中幸存者护理人员的血管危险因素。
肥胖女性护理人员是 swipe out stroke 的一部分，这是一项评估基于智能手机的干预措施在少数民族卒中幸存者中改变饮食的 I 期 PROBE 研究。在获得书面知情同意后，对患者和护理人员进行血管危险因素筛查。描述性统计用于描述研究人群。通过患者和护理人员的 2 样本 t 检验或 Wilcoxon 秩和检验比较连续基线变量。通过 Fisher 精确检验比较分类基线变量。
36 名卒中患者（63.9%非裔美国人，36.1%西班牙裔）和 13 名女性护理人员（69.2%非裔美国人，30.8%西班牙裔）入组。平均年龄，患者为 54.1（SD 9.4）岁，护理人员为 51.3（SD 15.6）岁，教育、就业状况和卒中或肥胖的家族史无显著差异。与卒中患者相比，女性护理人员报告高血压的可能性明显较低（69.2%比 97.2%；P=0.01）和高脂血症（16.7%比 60%；P=0.02）。女性护理人员的收缩压（147.6 比 127.7mmHg；P=0.05）、总胆固醇（207.5 比 167mg/dL；P=0.01）和低密度脂蛋白值（119.5 比 88mg/dL；P=0.03）均高于卒中患者。
使用聚类招募，我们发现与卒中患者相比，少数民族女性护理人员更容易出现未知或控制不佳的血管危险因素。创新的健康筛查工具可能有益于参与临床试验的少数民族患者的大家庭。
