title: The Association between Changes in Behavioral Risk Factors for Stroke and Changes in Blood Pressure.
abstract: BACKGROUND
  High blood pressure (BP) is the leading risk factor for stroke. Data on the association of physical activity (PA), fruit and vegetable (F&V) consumption, and dietary sodium with hypertension are lacking in Hispanic communities. In the current report, we provide data on the association between changes in these stroke behavioral risk factors and BP change.
  
  
  METHODS
  Participants were recruited from participating Catholic churches in Nueces County, Texas. BP was measured, and self-reported validated scales of F&V consumption, dietary sodium, and PA were collected at baseline and at 12 months. Linear mixed models were used to examine the associations between tertiles of improvement in the 3 behavior outcomes and BP change, adjusted for demographic characteristics. The association between the binary measure of at least 5 mmHg diastolic blood pressure (DBP) or 10 mmHg systolic blood pressure (SBP) reduction and behavior change was estimated with multilevel logistic regression models.
  
  
  RESULTS
  Of 586 participants, 66% were female and 82% were Mexican American (MA), and the mean age was 54 years. High compared with low change in PA was significantly associated with DBP change (P = .022), and high compared with low change in F&V intake was significantly associated with SBP change (P = .032). For the binary changes in DBP or SBP, there was a borderline association of PA (P = .054); all other variables were not associated (P > .10).
  
  
  CONCLUSIONS
  PA and F&V consumption are potential stroke prevention targets in predominantly MA populations.
authors.affiliation: Stroke Program, University of Michigan Health System; Department of Epidemiology, University of Michigan School of Public Health. Electronic address: Lmorgens@umich.edu.
authors.forename: Lewis B
authors.initials: LB
authors.lastname: Morgenstern
authors.affiliation: Department of Biostatistics, University of Michigan School of Public Health.
authors.forename: Brisa N
authors.initials: BN
authors.lastname: Sánchez
authors.affiliation: School of Health Promotion and Human Performance, Eastern Michigan University.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Conley
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health.
authors.forename: Melany C
authors.initials: MC
authors.lastname: Morgenstern
authors.affiliation: Stroke Program, University of Michigan Health System.
authors.forename: Emma
authors.initials: E
authors.lastname: Sais
authors.affiliation: Stroke Program, University of Michigan Health System.
authors.forename: Lesli E
authors.initials: LE
authors.lastname: Skolarus
authors.affiliation: Department of Medicine, University of Michigan Health System and VA Ann Arbor Health System.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Levine
authors.affiliation: Stroke Program, University of Michigan Health System.
authors.forename: Devin L
authors.initials: DL
authors.lastname: Brown
mesh_terms: D000368:Aged; D001526:Behavioral Symptoms / Q000453:epidemiology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D014676:Diet, Vegetarian / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D012307:Risk Factors; D012982:Sodium, Dietary / Q000008:administration & dosage; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology*
chemical_list: D012982:Sodium, Dietary
keywords: Hispanic; fruit and vegetable; hypertension; physical activity; sodium; stroke prevention