Demographic, Clinical and Social Determinants of Blood Pressure Control Among Black men who have had Stroke or Transient Ischemic Attack

BACKGROUND: This analysis of baseline data from a clinical trial evaluated factors associated with blood pressure (BP) control among 160 Black men with stroke or transient ischemic attack (TIA). METHODS: Aggregate analysis evaluated demographic (age, health insurance status, living-alone status), clinical (time since stroke/TIA, somatic comorbidities), and social variables (health literacy, stress and discrimination) in relation to BP. Baseline BP readings were available for 146 (91.3%) of the sample. RESULTS: Mean sample age was 61.19 (Standard deviation/SD of 9.47) years and mean level of education was 13.99 (SD 2.19) years. Baseline systolic and diastolic BP were 134.59 (SD 17.80) and 82.59 (SD 12.17) respectively. Mean body mass index (BMI) was 30.6 (SD 6.59) and nearly half of the sample (N = 79, 49.38%) had diabetes. In unadjusted analyses, higher health literacy was associated with higher systolic BP (r=.279, p=.002). Higher diastolic BP was associated with lower age (r=-.370, p<.001), less education (r=-.216, p=.012), being unmarried (r=-.247, p=.003), living alone (r=.212, p=.011), having Medicaid (r=.189, p=.024), and higher health literacy (r=.257, p=.005). After age adjustment, the only significant association with systolic BP was health literacy (r=.276, p=.002) while the only significant associations with diastolic BP were education (r=-.187, p=.030) being unmarried (r=-.199, p=.021), living alone (r=.232 p=.007), and health literacy (r=.259, p=.004). CONCLUSIONS: While our analysis found few significant correlates of elevated BP among Black men with stroke or TIA, these individuals may still be at risk for stroke recurrence given high BMI, limited social support, and vulnerability to attenuation of healthy behaviors.