Abstract P149: Rural Residence And Blood Pressure Medication Use In United States Stroke Survivors, 2019 Behavioral Risk Factor Surveillance System Survey

Background: Over the last two decades, recurrent stroke rates and hypertension rates have increased significantly in rural US areas. Blood pressure medication use is associated with lower recurrent stroke risk, but information on blood pressure medication use after stroke in rural areas is limited. We sought to compare blood pressure medication use in US stroke survivors living in rural versus urban areas. Methods: We identified US stroke survivors with hypertension in the national 2019 Behavioral Risk Factor Surveillance System survey. The survey-weighted prevalence of current blood pressure medication use was determined by rural and urban residence status. Survey-weighted logistic regression was used to calculate unadjusted Odds Ratios (OR) of current blood pressure medication use as well as ORs adjusted for stroke/hypertension related sociodemographic factors. We further stratified blood pressure medication use by other lifestyle factors in rural and urban settings. Results: Our study included 51,161 people who had a stroke, of which 18,097 were rural residents ( Table ). In weighted analyses, medication use was comparable for rural and urban residents. Stroke survivors in rural areas had similar odds of medication use as those in urban areas before and after risk-adjustment. Medication use did not vary by smoking status, physical inactivity, and high cholesterol between rural and urban residents. Conclusions: Overall, post-stroke blood pressure medication use was high and did not differ by rural/urban status or lifestyle factors. Other factors such as post-discharge care may have a greater impact on recurrent stroke rates in US rural areas.

Association Between Cardiometabolic Factors and Dizziness in African Americans: The Jackson Heart Study

Background Balance dysfunction is a complex, disabling health condition that can present with multiple phenotypes and etiologies. Data regarding prevalence, characterization of dizziness, or associated factors is limited, especially in an African American population. Purpose The aim of the study is to characterize balance dysfunction presentation and prevalence in an African American cohort, and balance dysfunction relationship to cardiometabolic factors. Research Design The study design is descriptive, cross sectional analysis. Study Sample The study sample consist of N = 1,314, participants in the Jackson Heart Study (JHS). Data Collection and Analysis JHS participants were presented an initial Hearing health screening questionnaire (N = 1,314). Of these, 317 participants reported dizziness and completed a follow-up Dizziness History Questionnaire. Descriptive analysis was used to compare differences in the cohorts' social-demographic characteristics and cardiometabolic variables to the 997 participants who did not report dizziness on the initial screening questionnaire. Based on questionnaire responses, participants were grouped into dizziness profiles (orthostatic, migraine, and vestibular) to further examine differences in cardiometabolic markers as related to different profiles of dizziness. Logistical regression models were adjusted for age, sex, education, reported noise exposure, and hearing sensitivity. Results Participants that reported any dizziness were slightly older and predominantly women. Other significant complaints in the dizzy versus nondizzy cohort included hearing loss, tinnitus, and a history of noise exposure (p < 0.001). Participants that reported any dizziness had significantly higher prevalence of hypertension, blood pressure medication use, and higher body mass index (BMI). Individuals with symptoms alluding to an orthostatic or migraine etiology had significant differences in prevalence of hypertension, blood pressure medication use, and BMI (p < 0.001). Alternatively, cardiometabolic variables were not significantly related to the report of dizziness symptoms consistent with vestibular profiles. Conclusion Dizziness among African Americans is comparable to the general population with regards to age and sex distribution, accordingly to previously published estimates. Participants with dizziness symptoms appear to have significant differences in BMI and blood pressure regulation, especially with associated orthostatic or migraine type profiles; this relationship does not appear to be conserved in participants who present with vestibular etiology symptoms.

Hydralazine Associated Antineutrophil Cytoplasmic AntibodyAssociated Vasculitis with Glomerulonephritis and Dsdna Antibody

Hydralazine is a very commonly used blood pressure medication. Though safe it can be associated with a lupus-like syndrome and antineutrophil cytoplasmic antibody-associated vasculitis due to its immunogenic nature, and rarely pulmonary-renal syndrome which can be fatal if not recognized promptly. Here we describe a case of hydralazine induced vasculitis with glomerulonephritis with positive dsDNA antibody, but the biopsy showed tubular injury with RBC casts and glomerulonephritis. We use this case to review the current literature and discuss the importance of early diagnosis, treatment options, and clinical outcomes of this rare complication from hydralazine use.