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Abstract 9398: Associations Between Blood Pressure, Race/Ethnicity, and Incident Stroke Type: A Pooled Cohort Analysis of ARIC, CARDIA, CHS, MESA, FOS, NOMAS

2022; Lippincott Williams & Wilkins; Volume: 146; Issue: Suppl_1 Linguagem: Inglês

10.1161/circ.146.suppl_1.9398

1524-4539

Kimson Johnson, Hanyu Li, Min Zhang, Mellanie V. Springer, Andrzej T. Gałecki, Rachael T. Whitney, Rebecca F. Gottesman, Rodney A. Hayward, Stephen Sidney, Mitchell S.V. Elkind, Ralph L. Sacco, W.T. Longstreth, Susan R. Heckbert, Yariv Gerber, Kevin Sullivan, Deborah A. Levine,

Acute Ischemic Stroke Management

Introduction: Stroke risk varies by systolic blood pressure (SBP) and race/ethnicity. Whether the relationship between cumulative mean SBP and first-time incident stroke type differs by racial/ethnic group is unknown. This study examines the relationship between cumulative mean SBP and first-time incident stroke among 3 major stroke types: ischemic stroke (IS), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and how race/ethnicity influences these relationships, using a pooled cohort analysis. Hypothesis: We hypothesize that race/ethnicity modifies the association between cumulative mean SBP and incident stroke type. Methods: Data were pooled from 38,325 participants with baseline age ≥18 and ≥1 SBP measurement before the first incident stroke from 6 US longitudinal cohorts from 1971 to 2019: Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, Multi-Ethnic Study of Atherosclerosis, and Northern Manhattan Study. A multivariable-adjusted Cox proportional hazard model was used to estimate the association between cumulative mean SBP, race/ethnicity, and time to incident stroke (overall, stroke type, and race/ethnicity*stroke type). Results: Median follow-up was 22.3 years. Mean (SD) baseline age was 53.2 (17.1) years, with 54.5% female, 24.9% Black, and 8.8% Hispanic. Baseline mean (SD) SBP was 136.8 (20.5) mmHg. Race/ethnicity modified the association of SBP with time to ICH (P-interaction=0.006) but no other stroke types. Compared to White participants, the association between higher SBP on ICH risk was greater in Black participants but not different in Hispanic participants (Table). A 10-mmHg higher SBP was associated with a higher risk of ICH than IS (Table). Conclusions: We found that race modifies the association between SBP and ICH risk, such that ICH risk is 19% higher per 10-mmHg for Black individuals than White individuals.