Evidence map›Paper›PMID 39038094›Full record

ArticleStroke2024

Trends in Black-White Differences of Antihypertensive Treatment in Individuals With and Without History of Stroke.

Brian Stamm, Regina Royan, Jinhong Cui, D Leann Long, Christina M Lineback, Oluwasegun P Akinyelure, Timothy B Plante, Deborah A Levine, Virginia J Howard, George Howard and 1 more

Abstract read
In one paragraph

Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Brian StammDepartment of Neurology (B.S., C.M.L., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0002-0862
Regina RoyanDepartment of Emergency Medicine (R.R.), University of Michigan, Ann Arbor.ORCID 0000-0002-2645
Jinhong CuiDepartment of Biostatistics (J.C., D.L.L., G.H.), University of Alabama at Birmingham.
D Leann LongDepartment of Biostatistics (J.C., D.L.L., G.H.), University of Alabama at Birmingham.
Christina M LinebackDepartment of Neurology (B.S., C.M.L., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0003-2048-333X
Oluwasegun P Akinyelureepartment of Epidemiology (O.P.A., V.J.H.), University of Alabama at Birmingham.ORCID 0000-0002-3066
Timothy B PlanteDepartment of Medicine, University of Vermont, Burlington (T.B.P.).ORCID 0000-0001-9992
Deborah A LevineDepartment of Neurology (B.S., C.M.L., D.A.L.), University of Michigan, Ann Arbor.ORCID 0000-0002-6864
Virginia J Howardepartment of Epidemiology (O.P.A., V.J.H.), University of Alabama at Birmingham.ORCID 0000-0003-4912
George HowardDepartment of Biostatistics (J.C., D.L.L., G.H.), University of Alabama at Birmingham.ORCID 0000-0002-3068
Philip B GorelickDepartment of Neurology (B.S., P.B.G.), Northwestern University, Chicago, IL.ORCID 0000-0002-1181

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsRF1NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2024 to 2024
$16.2M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsR01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MARY CUSHMAN, VIRGINIA J. HOWARD · 2001 to 2026
$8.8M
NINDS NIH HHS R01 NS041588NINDS NIH HHS RF1 NS041588NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

backgroundRecent hypertension guidelines for the general population have included race-specific recommendations for antihypertensives, whereas current stroke-specific recommendations for antihypertensives do not vary by race. The impact of these guidelines on antihypertensive regimen changes over time, and if this has varied by prevalent stroke status, is unclear.

methodsThe use of antihypertensive medications was studied cross-sectionally among self-identified Black and White participants, aged ≥45 years, with and without history of stroke, from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke). Participants completed an in-home examination in 2003-2007 (visit 1) with/without an examination in 2013-2016 (visit 2). Stratified by prevalent stroke status, logistic regression mixed models examined associations between antihypertensive class use for visit 2 versus visit 1 and Black versus White individuals with an interaction adjusted for demographics, socioeconomic status, and vascular risk factors/vital signs.

resultsOf 17 244 stroke-free participants at visit 1, Black participants had greater adjusted odds of angiotensin-converting enzyme inhibitor usage than White participants (odds ratio [OR], 1.51 [95% CI, 1.30-1.77]). This difference was smaller in the 7476 stroke-free participants at visit 2 (OR, 1.16 [95% CI, 1.08-1.25]). In stroke-free participants at visit 1, Black participants had lower odds of calcium channel blocker (CCB) usage than White participants (OR, 0.47 [95% CI, 0.41-0.55]), but CCB usage did not differ significantly between Black and White stroke-free participants at visit 2 (OR, 1.02 [95% CI, 0.95-1.09]). Among 1437 stroke survivor participants at visit 1, Black participants had lower odds of CCB use than White participants (OR, 0.34 [95% CI, 0.26-0.45]). In 689 stroke survivor participants at visit 2, CCB use did not differ between Black and White participants (OR, 0.80 [95% CI, 0.61-1.06]).

conclusionsRacial differences in the use of guideline-recommended antihypertensives decreased between 2003-2007 and 2013-2016 in stroke-free individuals. In stroke survivors, racial differences in CCB usage narrowed over the time periods. These findings suggest there is still a mismatch between race-specific hypertension guidelines and recent clinical practice.

Indexed as

Antihypertensive AgentsBlack or African AmericanHypertensionStrokeAgedAngiotensin-Converting Enzyme InhibitorsCalcium Channel BlockersCross-Sectional StudiesFemaleHumansMaleMiddle AgedWhiteAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsCalcium Channel Blockersantihypertensive agentscalcium channel blockershypertensionracial groupsstroke

Identifiers

PMID39038094
PMCPMC11770882

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.