title: Racial and geographic differences in prevalence, awareness, treatment and control of dyslipidemia: the reasons for geographic and racial differences in stroke (REGARDS) study.
abstract: OBJECTIVE
  There are racial and geographic disparities in stroke mortality, with higher rates among African Americans (AAs) and those living in the southeastern US ('stroke belt'). Racial and geographic differences in dyslipidemia prevalence, awareness, treatment and control may, in part, account for the observed disparities in stroke mortality.
  
  
  METHODS
  Reasons for Geographic and Racial Differences in Stroke (REGARDS) is a national observational study of community-dwelling black and white participants aged 45 and older, with oversampling from the stroke belt. As of January 15, 2007, 26,122 participants were enrolled and a fasting lipid panel was available of 21,068. Awareness, treatment and control of dyslipidemia were estimated overall and compared across race-sex-region strata.
  
  
  RESULTS
  There were 55% of the participants with dyslipidemia and no racial differences in prevalence. Adjusting for demographic and established stroke risk factors, AAs had a lower prevalence (OR 0.74; 95% CI: 0.66, 0.77) and were less likely to be aware (0.69; 0.61, 0.78), treated (0.77; 0.67, 0.89) and controlled (0.67; 0.58, 0.77) than whites. There was lower control outside of the stroke belt (0.87; 0.76, 0.99).
  
  
  CONCLUSIONS
  Racial, but not geographic, differences in dyslipidemia management may play a role in the excess stroke burden in the Southeast.
authors.affiliation: Division of Neurology, Sentara Medical Group and Department of Neurology, Eastern Virginia Medical School, Norfolk, VA 23507, USA. rmzweifl@sentara.com
authors.forename: Richard M
authors.initials: RM
authors.lastname: Zweifler
authors.forename: Leslie A
authors.initials: LA
authors.lastname: McClure
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Martha K
authors.initials: MK
authors.lastname: Hovater
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.forename: George
authors.initials: G
authors.lastname: Howard
authors.forename: David C
authors.initials: DC
authors.lastname: Goff
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D050171:Dyslipidemias / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D044465:White People