After one year of aggressive medical management, diastolic BP and physical activity scores no longer differ for Blacks, non-Blacks.
After one year of intensive medical management, certain risk factors associated with stroke are reduced among Black adults, according to a study published online Aug. 3 in Stroke.
Eyad Almallouhi, M.D., from the Medical University of South Carolina in Charleston, and colleagues conducted a randomized controlled trial involving patients with symptomatic intracranial atherosclerotic stenosis to examine whether aggressive medical management ameliorates disparities in risk factor control between Black and non-Black patients (104 and 347, respectively). Risk factor frequency at study entry and mean levels of systolic and diastolic blood pressure, low-density lipoprotein, hemoglobin A1c, and exercise level at baseline and one year of follow-up were compared between Black and non-Black patients.
The researchers identified significant differences at baseline for Black versus non-Black patients in age (57.5 versus 61.0 years), hypertension (95.2 versus 87.5 percent), diabetes (52.9 versus 39.7 percent), mean diastolic blood pressure (82.4 versus 79.5 mm Hg), and mean physician-based assessment and counseling for exercise score (2.7 versus 3.3). At one year, mean diastolic blood pressure and mean physician-based assessment and counseling for exercise scores in Black versus non-Black patients were 74.7 versus 75.5 mm Hg and 4.2 versus 4.1, respectively, which were not significantly different. At one year, no disparities in other modifiable risk factors emerged.
“Our study found these disparities may be resolved by tailoring care to include lifestyle coaching, medication alterations or additions if appropriate, access to routine health care support, and regular physician follow-up,” a coauthor said in a statement.
Two authors disclosed ties to the pharmaceutical industry; AstraZeneca supplied study medications, and Stryker Corporation supplied endovascular devices.
Abstract/Full Text (subscription or payment may be required)
