Abstract

We propose to use data from the National Health and Nutrifion Examinafion Survey (NHANES) to describe racial differences over time in patterns of traditional stroke risk factors, novel biologic and social risk factors for stroke, and stroke risk scores. To better understand racial differences in the association between both traditional and non-traditional biological and social risk factors and the mechanisms underiying these relationships, we propose to address the following aims using data from NHANES:
Aim 1 : To describe trends in prevalence and control of tradifional stroke risk factors in NHANES III (1988- 1994) and NHANES 1999-2010 and how the trends differ among whites, African Americans, and Mexican Americans.
Aim 2 : To describe trends in non-traditional social risk factors for stroke (e.g. neighborhood characteristics) and novel biologic stroke risk factors (e.g. hsCRP, fibrinogen, and Lp(a)) in NHANES III and NHANES 1999-2010 and how the trends differ by race/ethnicity.
Aim 3 : To describe trends in 10-year stroke risk, 10-year CVD risk, and allostatic load, an index of cumulative biologic risk, using NHANES III and NHANES 1999-2010 and how the trends differ by race/ethnicity.
Aim 4 : Among stroke survivors in NHANES III and NHANES 1999-2004, to examine the associafion between mortality and novel biologic and social risk factors, after adjustment for traditional risk factors. We will also explore racial/ethnic differences in these associations. The use of NHANES data allows for detailed assessments of stroke risk factors and outcomes linked to extensive treatment, biomarker, geographic, and mortality data in a representative sample of U.S. adults.

Public Health Relevance

The proposed study will address gaps in our knowledge about racial/ethnic differences in trends in nontraditional biologic and social risk factors for stroke risk and outcomes. Enhanced understanding of these risk relationships is essential to any future efforts to develop more effective interventions to prevent strokes and reduce post-stroke morbidity and mortality.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54NS081764-02
Application #
8551801
Study Section
Special Emphasis Panel (ZNS1-SRB-N)
Project Start
Project End
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
2
Fiscal Year
2013
Total Cost
$300,624
Indirect Cost
$105,414

  Institution

Name
University of California Los Angeles
Department
Type
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095

  Publications

Cheng, Eric M; Cunningham, William E; Towfighi, Amytis et al. (2018) Efficacy of a Chronic Care-Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors: A Randomized Controlled Trial. Circ Cardiovasc Qual Outcomes 11:e003228
Bharmal, Nazleen H; McCarthy, William J; Gadgil, Meghana D et al. (2018) The Association of Religious Affiliation with Overweight/Obesity Among South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Relig Health 57:33-46
Ramirez, Magaly; Wu, Shinyi; Ryan, Gery et al. (2017) Using Beta-Version mHealth Technology for Team-Based Care Management to Support Stroke Prevention: An Assessment of Utility and Challenges. JMIR Res Protoc 6:e94
Towfighi, Amytis; Cheng, Eric M; Ayala-Rivera, Monica et al. (2017) Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Dispariti BMC Neurol 17:24
Cheng, Eric M; Myers, Laura J; Vassar, Stefanie et al. (2017) Impact of Hospital Admission for Patients with Transient Ischemic Attack. J Stroke Cerebrovasc Dis 26:1831-1840
Baca, Christine B; Barry, Frances; Vickrey, Barbara G et al. (2017) Social outcomes of young adults with childhood-onset epilepsy: A case-sibling-control study. Epilepsia 58:781-791
Ramirez, Magaly; Wu, Shinyi (2017) Phone Messaging to Prompt Physical Activity and Social Support Among Low-Income Latino Patients With Type 2 Diabetes: A Randomized Pilot Study. JMIR Diabetes 2:e8
Bharmal, Nazleen; Lucas-Wright, Anna Aziza; Vassar, Stefanie D et al. (2016) A Community Engagement Symposium to Prevent and Improve Stroke Outcomes in Diverse Communities. Prog Community Health Partnersh 10:149-58
Robinson, Maisha T; Vickrey, Barbara G; Holloway, Robert G et al. (2016) The lack of documentation of preferences in a cohort of adults who died after ischemic stroke. Neurology 86:2056-62
Lin, Michelle P; Ovbiagele, Bruce; Markovic, Daniela et al. (2016) Association of Secondhand Smoke With Stroke Outcomes. Stroke 47:2828-2835

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