Abstract Details

Title Racial Disparities in Mental Health Among Stroke Survivors in the REDUCE Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-014

Objective To compare mental health status between Black and Non-Black patients recovering from stroke.

Background One in three patients in the U.S. are diagnosed with depression after their stroke. This analysis focuses on mental health scores as opposed to clinical diagnoses of depression, broadening its applicability. Mental health disparities between racial groups are a significant concern, given that racial minorities face worse health outcomes following a stroke.

Design/Methods The REDUCE trial is an ongoing, multicenter, open label, randomized clinical trial comparing standard of care anti-hypertensive medication regimens vs spironolactone-containing regimens in stroke patients. Mental health scores are collected from patients post-stroke through the PROMIS Global Health survey. The raw total Mental Health score is then converted to a T-score. We evaluated whether there was a difference in Mental Health scores using an unpaired t-test followed by a linear regression to account for the influence of demographic and clinical variables.

Results

113 (62.9±11.8, 63% male, 62% White) patients have completed the PROMIS questionnaire during REDUCE enrollment post-stroke. Black patients (n=35) had a lower mean Mental Health T-score than Non-Black patients (n=78; 70 White, 2 Asian, 6 Unknown) (43.4±10.9 vs 48.3±9.5, p=0.014). PROMIS considers the threshold for between group comparisons as 3.0 T-score points. Mental health scores remained significantly lower for Black patients after controlling for demographics (age, sex, ethnicity, education, household net worth) and clinical variables (PROMIS Physical Health, mRS, MOCA, number of medications, hypertension, and time since stroke) (p=0.002, β=6.576, 95.0% CI[2.389, 10.762]).

Conclusions This study demonstrates a significant difference in PROMIS Mental Health scores between Black and Non-Black patients recovering from stroke in the REDUCE trial. The lack of available pre-stroke mental health history is a limitation in this analysis. These findings emphasize the importance of targeted interventions to specific groups and the need to further address underlying factors contributing to this disparity.

Authors/Disclosures
Hailey Brigger PRESENTER	Ms. Brigger has nothing to disclose.
Rachel Forman, MD (Yale Neurology)	Dr. Forman has nothing to disclose.
Emma S. Peasley (Yale School of Medicine)	Miss Peasley has nothing to disclose.
Ian P. Johnson	Mr. Johnson has nothing to disclose.
Joel Smith, Clinical Researcher	Mr. Smith has nothing to disclose.
Alison Champagne	Mrs. Champagne has nothing to disclose.
Julia Zabinska	Ms. Zabinska has nothing to disclose.
Guido J. Falcone, MD (Yale School of Medicine)	The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Lauren H. Sansing, MD	Dr. Sansing has nothing to disclose.
Rohan Arora, MD	The institution of Dr. Arora has received research support from Bayer.
Carlos Mena-Hurtado (Yale University)	Carlos Mena-Hurtado has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Terumo. Carlos Mena-Hurtado has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BD. Carlos Mena-Hurtado has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Expert witness. The institution of Carlos Mena-Hurtado has received research support from Shockwave.
Munachi N. Okpala, NP (McGovern Medical School-Division of Adult Neurology, Stroke Team)	Ms. Okpala has nothing to disclose.
Cheryl Bushnell, MD, MHS (Wake Forest School of Medicine)	The institution of Dr. Bushnell has received research support from PCORI. The institution of Dr. Bushnell has received research support from NIH/NINDS. Dr. Bushnell has received intellectual property interests from a discovery or technology relating to health care. Dr. Bushnell has received publishing royalties from a publication relating to health care.
Michael T. Mullen, MD (Temple University)	Dr. Mullen has received publishing royalties from a publication relating to health care.
Jordana Cohen (University of Pennsylvania)	Jordana Cohen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Jordana Cohen has received research support from National Institutes of Health. Jordana Cohen has received publishing royalties from a publication relating to health care.
Debbie Cohen	Debbie Cohen has nothing to disclose.
Adam De Havenon, MD, FAAN (Yale University)	Dr. De Havenon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. De Havenon has or had stock in Certus.Dr. De Havenon has or had stock in TitinKM. The institution of Dr. De Havenon has received research support from NIH/NINDS. Dr. De Havenon has received publishing royalties from a publication relating to health care.
Steven R. Messe, MD, FAHA, FAAN (Hospital of the University of Pennsylvania)	Dr. Messe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novo Nordisk. Dr. Messe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Terumo. Dr. Messe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for WL Gore. The institution of Dr. Messe has received research support from WL Gore. The institution of Dr. Messe has received research support from Mallinkrodt. The institution of Dr. Messe has received research support from Biogen. Dr. Messe has received intellectual property interests from a discovery or technology relating to health care. Dr. Messe has received publishing royalties from a publication relating to health care. Dr. Messe has received personal compensation in the range of $500-$4,999 for serving as a Clinical Event Committee for the CONFORMAL left atrial appendage occlusion trial with Yale Cardiovascular Research Group.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care)	Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.

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