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

Stroke ◽  
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.

Abstract MP28: Nationwide Racial Disparities in Smoking Cessation After Stroke in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Neal S Parikh ◽  
Melvin Parasram ◽  
Yongkang Zhang ◽  
Saad Mir ◽  
Halina White ◽  
...  
Keyword(s):  
United States ◽  
Smoking Cessation ◽  
Racial Disparities ◽  
Race And Ethnicity ◽  
Recurrent Stroke ◽  
The United States ◽  
Smoking History ◽  
Behavioral Risk ◽  
Stroke Survivors ◽  
Cross Sectional

Introduction: Black Americans face a higher risk of recurrent stroke than White Americans, and the reasons are unclear. Smoking after stroke is associated with a higher risk of recurrence. We investigated whether there are racial disparities in smoking cessation among stroke survivors in the United States. Methods: We performed a cross-sectional analysis of data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, an annual, nationally representative health survey. Respondents are asked about medical conditions and health-related behaviors. We pooled data from 2013-2018, during which race and ethnicity were uniformly reported. We included respondents with prior stroke and any smoking history. The exposure was self-reported race, and the outcome was smoking cessation. We calculated the quit ratio, defined as the proportion of former smokers among ever smokers; this is a standard measure in population-based studies of smoking cessation. Survey procedures were used to estimate frequencies and summarize quit ratios by race. Multiple logistic regression was used to assess the association of Black race with smoking cessation, as compared to White race, while adjusting for age, gender, Hispanic ethnicity, education, income, health insurance, and the number of smoking-related health conditions (heart disease, lung disease, cancer) that may prompt cessation. Results: Among 4,374,011 Americans with a history of stroke and any smoking, the median age was 67 years (IQR, 58-76), and 45.7% were women; 15.4% were Black, 74.8% were White, and 9.8% reported other race. The crude quit ratio was 51.4% (95% CI, 49.0-53.7) in Black and 63.2% (95% CI, 62.4-64.1) in White stroke survivors. In unadjusted analyses, Black stroke survivors were less likely to have quit smoking than White stroke survivors (OR, 0.61; 95% CI, 0.55-0.68). This remained the case after accounting for differences in demographics and smoking-related comorbidities (OR, 0.85; 95% CI, 0.74-0.98). Conclusion: In this nationwide study, Black stroke survivors had lower smoking quit rates than White stroke survivors, even after accounting for group differences. Expanding access to smoking-cessation interventions may reduce disparities in recurrent stroke.

Prevalence of the metabolic syndrome between 1999 and 2014 in the United States adult population and the impact of the 2007–2008 recession: an NHANES study

2019 ◽  
Vol 44 (8) ◽  
pp. 861-868 ◽  
Author(s):  
Alexis Marcotte-Chénard ◽  
Thomas A. Deshayes ◽  
Ahmed Ghachem ◽  
Martin Brochu
Keyword(s):  
United States ◽  
Metabolic Syndrome ◽  
Adult Population ◽  
Density Lipoprotein ◽  
The United States ◽  
High Plasma ◽  
Dietary Intakes ◽  
The Metabolic Syndrome ◽  
Daily Energy ◽  
The Impact

To document changes in prevalence of the metabolic syndrome (MetS) in the United States adult population between 1999 and 2014 and to explore how variations in the dietary intakes explain changes in MetS prevalence and its components over time. A total of 38 541 individuals (aged 20–85 years; National Health and Nutrition Examination Survey 1999–2014) were studied. Outcome variables were MetS, waist circumference (WC), plasma high-density lipoprotein cholesterol (HDL-c), triglycerides, fasting glucose (FG) levels, resting systolic and diastolic blood pressure, dietary intakes (total daily energy, carbohydrates, proteins, fats, sodium, and alcohol intakes), the poverty income ratio (PIR) and sociodemographic data (age, sex, ethnicity). Overall, the prevalence of the MetS significantly increased between 1999 and 2014 (27.9% to 31.5%). High plasma FG levels and high WC increased between 1999 and 2014, while the prevalence of the other components of MetS decreased or remained stable. Interestingly, a significant peak in MetS prevalence was observed in 2007–2008 compared with 1999–2006 (34.4% vs 27.6%), accompanied by a concomitant increase in WC and plasma FG levels, as well as a decrease in plasma HDL-c. Finally, significant decreases were observed for the PIR, total daily energy intake, sodium, and all macronutrient intakes in 2007–2008 compared with 1999–2006 (all P < 0.01). Results showed that the MetS prevalence significantly increased between 1999 and 2014 in the United States adult population, with a peak in 2007–2008. Interestingly, the 2007–2008 peak in MetS prevalence was accompanied by decreases in the PIR, total daily energy, and macronutrients intakes, suggesting potential impact of the 2007–2008 recession.

Abstract 3356: Half the Stroke Survivors in the United States have Poorly Controlled Hypertension

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Amytis Towfighi ◽  
Daniela Markovic ◽  
Bruce Ovbiagele
Keyword(s):  
United States ◽  
Lifestyle Modification ◽  
Antihypertensive Agents ◽  
The United States ◽  
Self Report ◽  
Stroke Survivors ◽  
Antihypertensive Medications ◽  
Previous Stroke ◽  
Undiagnosed Hypertension ◽  
All Cause Mortality

Background: National guidelines recommend antihypertensive treatment to lower the risk of secondary strokes in both hypertensive and normotensive patients. The degree to which blood pressure (BP) is treated and controlled among stroke survivors in the US has not been systematically investigated. In this analysis of a nationwide database, we assessed recent patterns, predictors, and prognoses of antihypertensive drug use among survivors of a stroke. Methods: We reviewed prevalence and control of hypertension among adults with a history of stroke (based on self report) who participated in the National Health and Nutrition Examination Survey 1999 to 2004 with mortality follow-up through December 31, 2006. Logistic regression was used to determine predictors of poorly-controlled BP (>140/90) and non-treatment. Cox models were used to examine the association between antihypertensive use vs. all-cause mortality, adjusting for confounders. Results: Among 9,145 participants aged ≥40 years, 490 reported previous stroke, corresponding to 4,755,372 (4%) of US adults. Of those with previous stroke, 72% had known hypertension, 47% had poorly controlled hypertension, and 8% had undiagnosed hypertension. Compared to those not taking antihypertensive medications, those on treatment were more likely to be significantly older, male, black non-Hispanic, diabetic, with elevated levels of BP, total cholesterol, and body mass index. In multivariable analyses, age (OR per year 1.05, 95% CI 1.02-1.09), female sex (OR 1.43, 95% CI 1.14-1.79), Hispanic ethnicity (OR 1.76, 95% CI 1.24-2.49) and diabetes (OR 2.12, 95% CI 1.50-2.99) were associated with poorly controlled BP, while subjects who had a previous myocardial infarction (OR 0.66, 95%CI 0.45-0.97), drank alcohol (OR 0.62, 95% CI 0.42-0.90) or were overweight (OR 0.62, 95% CI 0.49-0.78) were less likely to have poorly controlled BP. Among those with poorly controlled BP, hypercholesterolemia (OR 1.30, 95% CI 1.07-1.57) and male sex (OR 1.33, 95% CI 1.06-1.63) were predictors of non-treatment, whereas current smoking (OR 1.59, 95% CI 1.32-1.92) or overweight (OR 1.92, 95% CI 1.32-2.78) were linked to treatment. Those on antihypertensive medications had lower rates of all-cause mortality but this result did not reach significance (adjusted HR 0.87; 95% CI 0.33-2.32), and was not influenced by baseline BP or number of antihypertensive agents. Conclusion: Rates of antihypertensive therapy and BP control among stroke survivors in the United States are poor. One in two stroke survivors has poorly controlled hypertension. Several medical and lifestyle modification factors could be potential targets of intervention to bridge this evidence-practice gap.

scholarly journals Prevalence of the Metabolic Syndrome in the United States, 2003-2012

JAMA ◽  
2015 ◽  
Vol 313 (19) ◽  
pp. 1973 ◽  
Author(s):  
Maria Aguilar ◽  
Taft Bhuket ◽  
Sharon Torres ◽  
Benny Liu ◽  
Robert J. Wong
Keyword(s):  
United States ◽  
Metabolic Syndrome ◽  
The United States ◽  
The Metabolic Syndrome
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