Are there differences in risk factor profiles and frequency of CT/MRI-based infarcts among African American stroke patients with and without hypertension? A report from the African American Antiplatelet Stroke Prevention Study (AAASPS).
BACKGROUND; African Americans (AAs) have a high risk of stroke and a high prevalence of cardiovascular risk factors. Little is known about stroke risk profiles among non-hypertensive AAs.


METHODS
African American Antiplatelet Stroke Prevention Study (AAASPS) enrollees with a history of hypertension (htn) were compared to those without htn for history of traditional cardiovascular risk factors and number and distribution of CT/MRI infarcts. Estimated odds ratios are presented describing the association between selected risk factors and htn status. The estimated odds ratios and 95% confidence intervals (CI) were obtained using multivariate logistic regression.


RESULTS
The database for this analysis included 1012 patients with htn and 74 patients without htn. When compared to those with htn, those without htn were more commonly men (59% vs. 46%; p = 0.030), current cigarette smokers (55% vs. 37%; p = 0.001), were younger (median age: 59 years vs. 62 years; p = 0.064), had higher education (11.7 +/- 2.9 vs. 11.1 +/- 3.1; p = 0.024), had a higher number of acute strokes of unknown cause (23% vs. 13%; p=0.060), and less commonly had a history of diabetes (25% vs. 41%; p = 0.007). Those without htn had a lower mean number of old infarcts on MRI (0.94 +/- 1.40 vs. 1.45 +/- 1.60; p = 0.045), and a higher number of mean recent infarcts on CT (1.30 +/- 1.15 vs. 0.93 +/- 1.01; p = 0.031). Multivariate analysis to predict those without htn showed that these patients were more likely to be current cigarette smokers (OR = 2.89; CI = 1.60,5.49) and have higher education (OR = 1.08, CI = 0.996,1.17), and were less likely to have old CT/MRI-based infarcts (OR = 0.46; CI = 0.26,0.76).


CONCLUSIONS
AAs without htn may have a different cardiovascular risk factor profile and CT/MRI profile than AAs with htn. This baseline profile among AAs without htn may predict lower stroke recurrence rates in this ongoing trial.
Whittley
Chandra Y
CY
Departments of Neurological Science and Preventive Medicine, Rush Medical College, Chicago, Illinois 60612, USA. cwhitt01@hotmail.com
Gorelick
Philip B
PB
Raman
Rema
R
Harris
Jeffrey
J
Richardson
DeJuran
D
D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology