title: Clinical features and racial/ethnic differences among the 3020 participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial.
abstract: This study examined the baseline characteristics, racial/ethnic differences, and geographic differences among participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) study. The SPS3 trial enrolled patients who experienced a symptomatic small subcortical stroke (lacunar stroke) within the previous 6 months and an eligible lesion on detected on magnetic resonance imaging. The patients were randomized, in a factorial design, to antiplatelet therapy (aspirin 325 mg daily plus clopidogrel 75 mg daily vs aspirin 325 mg daily plus placebo) and to one of two levels of systolic blood pressure targets ("intensive" [<130 mmHg] or "usual" [130-149 mmHg]). A total of 3020 participants were recruited from 81 clinical sites in 8 countries. In this cohort, the mean age was 63 years, 63% were men, 75% had a history of hypertension, and 37% had diabetes. The racial distribution was 51% white, 30% Hispanic, and 16% black. Compared with white subjects, black subjects were younger (mean age, 58 years vs 64 years; P <.001) and had a higher prevalence of hypertension (87% vs 70%; P <.001). The prevalence of diabetes was higher in the Hispanic and black subjects compared with the white subjects (42% and 40% vs 32%; both P <.001). Tobacco smoking at the time of qualifying stroke was much more frequent in the Spanish participants than in subjects from North America and from Latin America (32%, 22%, and 9%, respectively; P <.001). Mean systolic blood pressure at study entry was 4 mmHg lower in the Spanish subjects compared with the North American subjects (P <.01). The SPS3 cohort is the largest magnetic resonance imaging-defined series of patients with S3. Among the racially/ethnically diverse SPS3 participants, important differences in patient features and vascular risk factors could influence prognosis for recurrent stroke and response to interventions.
authors.affiliation: School of Nursing, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Carole L
authors.initials: CL
authors.lastname: White
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Szychowski
authors.forename: Ana
authors.initials: A
authors.lastname: Roldan
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Benavente
authors.forename: Edwin J
authors.initials: EJ
authors.lastname: Pretell
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
authors.forename: Carlos S
authors.initials: CS
authors.lastname: Kase
authors.forename: Antonio
authors.initials: A
authors.lastname: Arauz
authors.forename: Brett C
authors.initials: BC
authors.lastname: Meyer
authors.forename: Irene
authors.initials: I
authors.lastname: Meissner
authors.forename: Bart M
authors.initials: BM
authors.lastname: Demaerschalk
authors.forename: Leslie A
authors.initials: LA
authors.lastname: McClure
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Coffey
authors.forename: Lesly A
authors.initials: LA
authors.lastname: Pearce
authors.forename: Robin
authors.initials: R
authors.lastname: Conwit
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Irby
authors.forename: Kalyani
authors.initials: K
authors.lastname: Peri
authors.forename: Pablo E
authors.initials: PE
authors.lastname: Pergola
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hart
authors.forename: Oscar R
authors.initials: OR
authors.lastname: Benavente
mesh_terms: D001741:Black or African American; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D016009:Chi-Square Distribution; D000077144:Clopidogrel; D003920:Diabetes Mellitus / Q000208:ethnology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D013020:South America / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology / Q000517:prevention & control*; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors; D016896:Treatment Outcome; D044465:White People
chemical_list: D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin