Aggressive medical management may help reduce disparities in stroke risk factors

Black people who have had strokes have more cardiovascular risk factors than people who are not Black, 但这些风险可以通过强化干预来降低, 新的研究表明.

The study, 周四发表在美国心脏协会期刊《沙巴足球体育平台》上, found that Black adults who had strokes due to severe blockages of a major artery in the brain were younger, more likely to have high blood pressure and Type 2 diabetes and less likely to be physically active than their non-Black peers. 但一年的进取, individualized medical management improved their blood pressure levels and physical activity scores, 减少这些差距.

"Modifiable stroke risk factor differences between Black and non-Black adults were found at enrollment; however, our study showed they may be resolved by tailoring care to include 生活方式指导, 如有需要，更改或添加药物, 获得常规保健支持和定期医生随访," Dr. 该研究的合著者阿什利·尼尔森(Ashley Nelson)在一份报告中说 news release. 在研究的时候, Nelson was a neurology resident at the Medical University of South Carolina in Charleston.

"Intense risk factor management has an important role in improving or eliminating these risk factor disparities in Black adults,尼尔森说.

使用SAMMPRIS的健康数据, the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis study, 研究人员分析了药物使用和血管危险因素, 包括收缩压和舒张压, 低密度脂蛋白(“坏”胆固醇)和血糖水平, and physical activity scores for Black and non-Black people who had recently had strokes. Physical activity levels were measured using a self-assessed questionnaire that looked at how frequently participants got moderate and vigorous exercise on a weekly basis.

Researchers analyzed data for 104 Black adults and 347 non-Black adults at the beginning of the study and one year later. 非黑人参与者包括白人, Asian and Hispanic adults who were looked at collectively because none of the groups was large enough to analyze separately.

在入学时, 黑人研究参与者的平均年龄为57岁, 相比之下，非黑人参与者为61人. 大约95%的黑人参与者患有高血压，而黑人参与者的高血压患病率为87%.5%的非黑人参与者. 更多的黑人参与者(52人).9%的黑人患2型糖尿病，而非黑人(39%).7%). The Black adults also had higher average diastolic blood pressure readings, 82.4毫米汞柱对79毫米汞柱.5毫米汞柱，体力活动得分较低.

入学后, 参与者参加了为期一年的激进活动, medical management intervention that consisted of intensive medical control of blood pressure, cholesterol, diabetes, smoking and physical activity levels as well as 生活方式指导 and regular follow-up visits with health-care professionals.

经过一年的干预计划, the disparity in diastolic blood pressure (the "bottom" number in a measurement) shrank. 黑人参与者的平均舒张指数降至74.7毫米汞柱，而75毫米汞柱.5毫米汞柱. Diastolic blood pressure reflects pressure in blood vessels between heart beats. 正常读数低于80毫米汞柱.

“我们倾向于关注收缩压, yet diastolic blood pressure is also a good marker for cardiovascular health and the integrity of the blood vessels,尼尔森说. "Using a tailored approach resulted in better risk factor control for the participants."

The authors attributed the drop in diastolic blood pressure to a doubling of the percentage of Black participants taking blood pressure-lowering medications during the intervention year.

Disparities in physical activity also eroded at the end of the intervention year, with Black participants seeing a significant increase to their average score. 这一比例也略高于其他所有参与者.

The authors noted that their findings raise questions about other factors that may be playing a role in disparities.

"Many different approaches are needed to reduce and eliminate these disparities in Black adults,尼尔森说. “获得医疗保健, 生活方式指导, early follow-up and administration of appropriate medications after stroke may help to resolve it, 但不完全是在总体风险和所有基线差异方面."