Are racial differences in antihypertensive responsiveness reflected in usage after stroke?

Area of Science:

• Clinical Neurology
• Cardiovascular Medicine
• Pharmacology

Background:

• Differential antihypertensive drug responses are documented in Black populations.
• Understanding prescription patterns is crucial for optimizing stroke care.
• Ischemic cerebrovascular events require effective post-hospitalization management.

Purpose of the Study:

• To investigate if racial disparities in antihypertensive effectiveness are reflected in discharge medication practices.
• To compare antihypertensive prescription rates in Black patients versus other races following ischemic stroke hospitalization.

Main Methods:

• Analysis of discharge antihypertensive medication use from the California Acute Stroke Prototype Registry.
• Comparison of prescription rates between Black patients and all other races combined.
• Use of generalized estimating equations to identify factors associated with medication receipt.

Main Results:

• No significant differences in overall antihypertensive use were observed between Black patients (74%) and other races (69%).
• Specific categories of antihypertensives showed no significant disparity in prescription rates.
• A non-significant trend indicated more frequent diuretic use in Black patients (P = .12).

Conclusions:

• Discharge antihypertensive prescription patterns did not differ between Black patients and other races hospitalized with ischemic stroke or transient ischemic attack.
• Current prescribing practices may not account for known differential responses to antihypertensives in Black individuals.
• Further research is needed to align treatment strategies with observed pharmacological differences.