HealthDay Reporter
THURSDAY, March 4, 2021 (HealthDay News) – Even after suffering a stroke, many Hispanic Americans have uncontrolled diabetes, high blood pressure or other conditions that raise their risk of becoming a stroke. repeat, find new study.
The study included 404 Hispanic adults with a history of stroke or “minor stroke,” which is a brief reduction in blood flow to the brain that may follow a full-blown stroke. The researchers found that, despite these scares, many of their stroke risk factors were not controlled.
Sensitivity did not seem to be the issue: Most patients were known to have high blood pressure, high cholesterol or diabetes.
However, many did not have these conditions under good control, the study found.
“This shows that we have work to do,” said lead researcher Dr. Fernando Testai, associate professor of neurology at the University of Illinois at Chicago. “It’s a wake-up call for the medical community.”
The study, published online March 4 in the journal Stroke,this is not the first to find a high frequency of heart and blood disease risks among Hispanic Americans.
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According to the American Heart Association, more than half of Hispanic men and about 43% of Hispanic women in the United States have some form of cardiovascular disease.
The new study included a group of patients who, because of their history of stroke, should maintain strict control over illnesses such as high blood pressure and diabetes.
But that was not true.
“We found that less than half of patients who experienced high blood pressure had got their numbers to where we would have them be,” Testai said.
Meanwhile, only one-third of those with known high cholesterol had these numbers down, the results showed. And of patients who were aware that they had diabetes, a little more than a second was under good control.
The exact reasons are unclear. But there were many patients who were not receiving conventional medications: About half of them were on clot prevention drugs; even fewer were on cholesterol-lowering statins.
Testai identified some broad patterns that the study revealed.
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For example, older patients were less likely to have control of high blood pressure or diabetes. That could indicate problems with adhering to medication or lifestyle advice, Testai thought, or perhaps lower-level health care compared to younger patients.
In addition, patients who had lived in the United States longer tended to have worse diabetes control.
One possible explanation is that these patients were more exposed to the normal U.S. diet, and the abundance of calories from processed foods, Testai said.
Dr. José Biller, professor of neurology at Loyola University Chicago agreed.
“Dietary changes are often attributed to acculturation, and food is often used as a metaphor for citizenship,” said Biller, who is also a volunteer expert with the American Heart Association / American Stroke Association. “It’s what we eat. Everyone benefits from consuming less salt, staying active and maintaining healthy lifestyles.”
Biller also said patients may face “urgent” barriers that make it difficult to adhere to medications, from cost to consistent medical conditions to their own beliefs about the drugs.
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In some cases, Testai said, language can be a barrier. If doctors need to communicate through an interpreter, that can make it more difficult to create a strong provider – patient relationship, he explained.
Communication is crucial, Biller agreed. He said health care providers need “cultural ability” and skill for “active listening, and not talking down to patients.”
On a broader scale, Biller said, people living in communities that are “health care deserts” need better access to quality care.
In terms of what patients can do, Testai emphasized changes in diet, exercise and, when needed, weight loss.
“Medications are just part of the story,” he said. “It’s the sedentary lifestyle. It’s the diet.”
Testai pointed out that people do not need a gym membership for exercise. Getting physical activity during the day is what matters.
“Get out and walk around the block,” he said. “Take the stairs instead of the elevator. It’s about a complete lifestyle change.”
Find out more
The American Stroke Association has more on stroke prevention.
SOURCE: Fernando Testai, MD, PhD, associate professor, neurology, University of Illinois at Chicago; José Biller, MD, professor and chair, neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Ill., And volunteer specialist, American Heart Association / American Stroke Association, Dallas; Stroke, March 4, 2021, online