title: Racial-ethnic disparities in acute blood pressure after intracerebral hemorrhage.
abstract: OBJECTIVE
  To assess race-ethnic differences in acute blood pressure (BP) following intracerebral hemorrhage (ICH) and the contribution to disparities in ICH outcome.
  
  
  METHODS
  BPs in the field (emergency medical services [EMS]), emergency department (ED), and at 24 hours were compared and adjusted for group differences between non-Hispanic black (black), non-Hispanic white (white), and Hispanic participants in the Ethnic Racial Variations of Intracerebral Hemorrhage case-control study. Outcome was obtained by modified Rankin Scale (mRS) score at 3 months. We analyzed race-ethnic differences in good outcome (mRS ≤ 2) and mortality after adjusting for baseline differences and included BP recordings in this model.
  
  
  RESULTS
  Of 2,069 ICH cases enrolled, 30% were white, 37% black, and 33% Hispanic. Black and Hispanic patients had higher EMS and ED systolic and diastolic BPs compared with white patients (p = 0.0001). Although attenuated, at 24 hours after admission, black patients had higher systolic and diastolic BPs. After adjusting for baseline differences, significant race/ethnic differences persisted for EMS systolic, ED systolic and diastolic, and 24-hours diastolic BP. Only ED systolic and diastolic BP was associated with poor functional outcome, and no BP predicted mortality. We found no race-ethnic differences in 3-month functional outcome or mortality after adjusting for group differences, including acute BPs.
  
  
  CONCLUSIONS
  Although black and Hispanic patients had higher BPs than white patients at presentation, we did not find race-ethnic disparities in 3-month functional outcome or mortality. ED systolic and diastolic BP was associated with poor functional outcome, but not mortality, in this race-ethnically diverse population.
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH. skoch@med.miami.edu.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Koch
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Testai
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: W Mark
authors.initials: WM
authors.lastname: Brown
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Sharyl
authors.initials: S
authors.lastname: Martini
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Sheth
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Ji Y
authors.initials: JY
authors.lastname: Chong
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Osborne
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Moomaw
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Carl D
authors.initials: CD
authors.lastname: Langefeld
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: From the Miller School of Medicine (S.K., R.L.S.), University of Miami, FL; Columbia University (M.S.V.E.), New York, NY; University of Illinois (F.D.T.), Chicago; Wake Forest School of Medicine (W.M.B., C.D.L.), Winston-Salem, NC; Michael E. DeBakey VA Medical Center and Baylor College of Medicine (S.M.), Houston, TX; Yale University (K.N.S.), New haven, CT; Cornell University (J.Y.C.), Ithaca, NY; and University of Cincinnati (J.O., C.J.M., D.W.), OH.
authors.forename: Daniel
authors.initials: D
authors.lastname: Woo
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000208:ethnology* / Q000503:physiopathology*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data