Abstract Number: Esoc2026a1890 Ethnic and Socioeconomic Inequalities in Pre-Stroke Vascular Risk Factor Profiles: The South London Stroke Register 1995-2024

Abstract Background and aims Stroke disproportionately affects ethnic minority and lower socioeconomic groups. We investigated ethnic and socioeconomic inequalities and trends in pre-stroke vascular risk factor (VRF) profiles. Methods Population-based cohort study of adults with stroke (N=8, 515), stratified by ethnicity, occupation, and education. Associations between ethnicity, socioeconomic status and pre-stroke VRFs were calculated using Poisson regression. Results Mean age at stroke was 59. 6 years in Black Africans, 68. 1 in Black Caribbeans, and 71. 8 in White participants. 12. 0% of Black Africans had no pre-stroke risk factor diagnosis (White participants: 6. 3%). Black (vs White) participants and those with lower (vs higher) occupation or education had higher rates of hypertension (adjusted prevalence ratio: Black Caribbean 1. 29 95%CI: 1. 24-1. 34, Black African 1. 47 1. 40-1. 53, manual/routine occupation 1. 09 1. 05-1. 13, lower education 1. 06 1. 02-1. 11), and diabetes (Black Caribbean 2. 23 2. 04-2. 43, Black African 1. 92 1. 73-2. 13, manual/routine 1. 23 1. 13-1. 34, lower education 1. 21 1. 09-1. 37), but lower rates of atrial fibrillation (Black Caribbean 0. 57 0. 48-0. 68, Black African 0. 66 0. 54-0. 82, lower education 0. 78 0. 68-0. 91). Ethnic and socioeconomic inequalities in diabetes and hypertension widened over time but narrowed for atrial fibrillation. 36% of strokes occurred in people with at least one diagnosed, but untreated risk factor throughout the study period. Conclusions Hypertension- and diabetes-related strokes are more frequent and rising faster in ethnic minority and lower socioeconomic groups, driving incidence inequalities. Black people’s younger stroke age and higher proportion without pre-stroke VRF diagnosis warrant targeted and earlier primary prevention efforts to tackle health inequalities. Conflict of interest Eva Emmett: nothing to disclose; Camila PantojaRuiz: nothing to disclose; Amal Khanolkar: nothing to disclose; Charles Wolfe: nothing to disclose; Matthew O'Connell: nothing to disclose; Iain Marshall: nothing to disclose