Differences in Disability Among Black and White Stroke Survivors--United States, 2000-2001

Introduction: Patients with stroke face an increased risk of contracting influenza and herpes zoster. We compared vaccination rates in stroke survivors versus the general United States population. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System, which is an annual, nationally representative, health survey. Respondents are asked about medical conditions and care. We used the most recent years with complete data for influenza (2018) and zoster (2017). We utilized survey procedures to estimate CDC-recommended vaccination rates for influenza (annual vaccination for all) and zoster (one-time vaccination for those at least 50 years old). Multiple logistic regression was used to compare the odds of vaccination in those with and without prior stroke, while adjusting for demographics (including income and health insurance) and comorbidities that may influence vaccination rates (obesity, diabetes, heart disease, cancer, pulmonary disease, and smoking). Results: In 2018, 8,254,136 (3.4%; 95% CI, 3.3-3.5) Americans were stroke survivors. The influenza vaccination rate was 44.4% (95% CI, 42.8-46.2) in stroke survivors and 32.8% (95% CI, 32.5-33.1) otherwise. In unadjusted models, stroke survivors were more likely to have had an influenza vaccination in the past year than those without stroke (OR, 1.6; 95% CI, 1.5-1.8). In 2017, 5,839,186 (5.7%; 95% CI, 5.5-5.9) Americans over 50 years old (i.e., eligible for zoster vaccination) were stroke survivors. The zoster vaccination rate was 30.3% (95% CI, 28.8-32.0) in stroke survivors and 27.6% (95% CI, 27.3-28.0) in those without prior stroke. Stroke survivors were more likely to have had zoster vaccination than those without stroke (OR, 1.14; 95% CI, 1.06-1.23). However, after accounting for demographics and comorbidities, stroke survivors were not more likely to be vaccinated for influenza (OR, 1.01; 95% CI, 0.93-1.10) or zoster (OR, 1.00; 95% CI, 0.90-1.12). Conclusion: Stroke survivors were not vaccinated at higher rates than expected based on demographics and comorbidities, and absolute vaccination rates were low, especially for zoster. Efforts to increase vaccination after stroke may be needed.

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Abstract T P139: Rising Rates of the Metabolic Syndrome Among Stroke Survivors in the United States

Stroke ◽

10.1161/str.45.suppl_1.tp139 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Michael McManus ◽

Daniela Markovic ◽

Natalie Valle ◽

Bruce Ovbiagele ◽

Amytis Towfighi

Keyword(s):

United States ◽

Metabolic Syndrome ◽

Stroke Risk ◽

Recurrent Stroke ◽

Temporal Trends ◽

The United States ◽

Self Report ◽

Stroke Survivors ◽

Middle Aged ◽

The Metabolic Syndrome

BACKGROUND: Metabolic syndrome (MetS), a constellation of cardiometabolic risk factors clustering together, affects >47 million US adults and has been independently linked to primary and recurrent stroke risk. Prevalence and trends in MetS among stroke survivors in the United States are unknown. OBJECTIVES: To evaluate recent temporal trends in age and sex-specific MetS prevalence among adults with/without stroke in the US. METHODS: Prevalence of MetS was assessed among fasting adults ≥35 years who participated in National Health and Nutrition Examination Surveys 1999-2010 (n=9,343). Prevalence estimates were weighted to obtain nationally representative estimates (n=430,371,669). MetS was defined by the 2009 harmonized definition. Stroke was determined by self-report. RESULTS: In all groups except men 35-64 years, MetS prevalence was similar among adults with and without stroke in 1999-2002 (Table). MetS prevalence rates were flat from 1999 to 2010 among those without stroke, but increased among stroke survivors, such that up to 80% of men and 86% of women with stroke had MetS, with the greatest rise among the middle-aged. Stroke survivors aged 35-64 years were ~3 times more likely to have MetS than their counterparts without stroke (OR 3.24, 95% CI 1.60-6.55 for men and OR 2.55, 95% CI 1.45-4.50 for women). DISCUSSION: Due to a differential rise in MetS in stroke survivors over the last 10 years, as many as 9 out of 10 stroke survivors now have MetS, suggesting that Mets may increasingly be placing people at risk for stroke. Intensified efforts aimed at identifying and treating MetS, especially among middle-aged individuals, may be warranted to avert stroke risk.

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Abstract 15: Trends in Atrial Fibrillation-related Cardiovascular Mortality Rates in The United States: 1999-2017

Circulation ◽

10.1161/circ.141.suppl_1.15 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Yoshihiro Tanaka ◽

Nilay Shah ◽

Rod Passman ◽

Philip Greenland ◽

Sadiya Khan

Keyword(s):

United States ◽

Atrial Fibrillation ◽

Black Men ◽

Cause Of Death ◽

Age Groups ◽

White Men ◽

The United States ◽

Mortality Rates ◽

Men And Women ◽

Black And White

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and the prevalence is increasing due to the aging of the population and the growing burden of vascular risk factors. Although deaths due to cardiovascular disease (CVD) death have dramatically decreased in recent years, trends in AF-related CVD death has not been previously investigated. Purpose: We sought to quantify trends in AF-related CVD death rates in the United States. Methods: AF-related CVD death was ascertained using the CDC WONDER online database. AF-related CVD deaths were identified by listing CVD (I00-I78) as underlying cause of death and AF (I48) as contributing cause of death among persons aged 35 to 84 years. We calculated age-adjusted mortality rates (AAMR) per 100,000 population, and examined trends over time estimating average annual percent change (AAPC) using Joinpoint Regression Program (National Cancer Institute). Subgroup analyses were performed to compare AAMRs by sex-race (black and white men and women) and across two age groups (younger: 35-64 years, older 65-84 years). Results: A total of 522,104 AF-related CVD deaths were identified between 1999 and 2017. AAMR increased from 16.0 to 22.2 per 100,000 from 1999 to 2017 with an acceleration following an inflection point in 2009. AAPC before 2009 was significantly lower than that after 2009 [0.4% (95% CI, 0.0 - 0.7) vs 3.5% (95% CI, 3.1 - 3.9), p < 0.001). The increase of AAMR was observed across black and white men and women overall and in both age groups (FIGURE), with a more pronounced increase in black men and white men. Black men had the highest AAMR among the younger decedents, whereas white men had the highest AAMR among the older decedents. Conclusion: This study revealed that death rate for AF-related CVD has increased over the last two decades and that there are greater black-white disparities in younger decedents (<65 years). Targeting equitable risk factor reduction that predisposes to AF and CVD mortality is needed to reduce observed health inequities.

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