Department of Neurology and Rehabilitation (F.B., D.P., F.D.T.), University of Illinois at Chicago.
Institute for Minority Health Research (J.C., R.D.-A., M.L.D.), University of Illinois at Chicago.
Stroke. 2021 Apr;52(4):1339-1346. doi: 10.1161/STROKEAHA.120.031216. Epub 2021 Mar 4.
We investigated the prevalence, awareness, and control of vascular risk factors (VRFs) and the use of antithrombotic and statin agents in HCHS (Hispanic Community Health Study)/SOL (Study of Latinos) participants with self-reported history of stroke or transient ischemic attack.
Sociodemographic characteristics, medications, and prevalence of different VRFs were recorded. VRF diagnoses and goals were based on the recommendations of professional organizations. Factors associated with optimal VRF control and use of antithrombotic and statin agents were investigated using multivariate logistic regression.
The analysis included 404 participants (39% men). The prevalences of hypertension, dyslipidemia, and diabetes were 59%, 65%, and 39%, respectively. Among those who met the diagnostic criteria for these diagnoses, the frequencies of awareness were 90%, 75%, and 83%, respectively. In participants who were aware of their VRFs, the prevalences of controlled hypertension, dyslipidemia, and diabetes were 46%, 32%, and 54%. Approximately 46% of the participants were on antithrombotics, 39% on statins, and 26% on both. Only 38% of those with atrial fibrillation received anticoagulation. In multivariate analyses adjusted for baseline sociodemographic characteristics, older age was associated with uncontrolled hypertension and diabetes. Residing in the United States for ≥10 years and born in the United States were associated with uncontrolled diabetes, female sex with uncontrolled dyslipidemia, and lack of health insurance with decreased use of statins and hyperlipidemia.
Hispanic/Latino adults in the United States have high prevalence and awareness of VRFs but low adherence to secondary stroke prevention strategies. Older adults, women, and uninsured people are vulnerable groups that may benefit from targeted interventions. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02060344.
我们调查了有自述卒中或短暂性脑缺血发作史的 HCHS（西班牙裔社区健康研究）/SOL（拉丁裔研究）参与者中血管风险因素（VRF）的流行率、知晓率和控制率，以及抗血栓和他汀类药物的使用情况。
记录社会人口统计学特征、药物使用情况以及不同 VRF 的流行率。VRF 诊断和目标基于专业组织的建议。使用多变量逻辑回归分析了与最佳 VRF 控制和抗血栓及他汀类药物使用相关的因素。
分析包括 404 名参与者（39%为男性）。高血压、血脂异常和糖尿病的患病率分别为 59%、65%和 39%。在符合这些诊断标准的参与者中，知晓率分别为 90%、75%和 83%。在知晓 VRF 的参与者中，控制良好的高血压、血脂异常和糖尿病的患病率分别为 46%、32%和 54%。约 46%的参与者使用抗血栓药物，39%使用他汀类药物，26%同时使用两种药物。只有 38%的心房颤动患者接受了抗凝治疗。在调整了基线社会人口统计学特征的多变量分析中，年龄较大与未控制的高血压和糖尿病有关。在美国居住≥10 年和在美国出生与未控制的糖尿病有关，女性与未控制的血脂异常有关，没有医疗保险与他汀类药物使用率降低和血脂异常有关。
美国的西班牙裔/拉丁裔成年人 VRF 流行率和知晓率较高，但二级卒中预防策略的依从性较低。老年人、女性和没有医疗保险的人是弱势群体，可能需要有针对性的干预措施。注册：网址：https://www.clinicaltrials.gov；唯一标识符：NCT02060344。
