Abstract Details

Title Neighborhood Deprivation and Disparities in Blood Pressure Monitoring in Patients with Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-018

Objective To test whether neighborhood deprivation was associated with blood pressure (BP) monitoring and whether missing BP around ICH predicted subsequent uncontrolled BP.

Background Patients in socioeconomically disadvantaged neighborhoods face barriers to care. Missing BP documentation may signal gaps in risk-factor management, a crucial component of primary and secondary prevention of intracerebral hemorrhage (ICH).

Design/Methods We conducted a case-only study within the NIH All of Us Research Program. We included ICH survivors (surviving ≥1-year) with available ZIP3-based social deprivation index (zSDI). Deprivation was categorized as Low, Medium, or High using cohort-based tertiles. We excluded BP measurements collected by All of Us. Outcomes were (1) zero BP assessments and (2) uncontrolled BP (mean systolic BP ≥140 mmHg) during three windows: 0–365 days before ICH; 30–365 days and 1–5 years after ICH. Multivariable logistic regression tested associations.

Results 2,439 ICH survivors were included (mean age 61.2, 48.7% female). Compared to low deprivation, those living in high deprivation neighborhoods had higher risk of absent BP assessments in the year prior to ICH (OR 2.32, 95% CI 1.88–2.87; p<0.001), 30–365 days post-ICH (OR 2.59, 2.09–3.20; p<0.001) and 1–5 years post-ICH (low vs high, OR 2.86, 95% CI 2.31–3.54; p<0.001). Absence of BP assessments in the year before ICH predicted uncontrolled hypertension 30-365 days (OR 1.69, 95% CI 1.25–2.28; p<0.001; N=1,483) and 1–5 years (OR 1.88, 1.42–2.50; p<0.001; N=1,426) after ICH. Absence of BP assessments 30–365 days post-ICH also predicted uncontrolled BP 1–5 years post-ICH (OR 1.88, 95% CI 1.40–2.52; p<0.001; N=1,426).

Conclusions Neighborhood deprivation is associated with persistent gaps in BP documentation surrounding ICH, and missing BP assessments before or soon after ICH predicts subsequent hypertension. These findings highlight the need for systemic solutions that ensure equitable BP assessment for socioeconomically disadvantaged populations.

Authors/Disclosures
Samuel G. Namian PRESENTER	Mr. Namian has nothing to disclose.
Joel Smith, Clinical Researcher	Mr. Smith has nothing to disclose.
Sofia Constantinescu, BS	Ms. Constantinescu has nothing to disclose.
Yome Tawaldemedhen, MD	Dr. Tawaldemedhen has nothing to disclose.
Cyprien Rivier, MD (Yale University)	Dr. Rivier has nothing to disclose.
Santiago Clocchiatti-Tuozzo (Yale University, Department of Neurology)	Mr. Clocchiatti-Tuozzo has nothing to disclose.
Shufan Huo, MD, PhD (Yale University)	Dr. Huo has nothing to disclose.
Kane Wu	An immediate family member of Mr. Wu has received personal compensation for serving as an employee of Bristol-Myers Squibb. Mr. Wu has received research support from NIH.
Rachel Forman, MD (Yale Neurology)	Dr. Forman has nothing to disclose.
Victor M. Torres-Lopez, MA (Yale University)	Mr. Torres-Lopez has nothing to disclose.
N. Abimbola Sunmonu, MD, PhD (Yale Neurology)	Dr. Sunmonu has nothing to disclose.
Nils Petersen, MD (Yale University)	The institution of Dr. Petersen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Silkroad Medical. Dr. Petersen has received research support from NIH.
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.

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