Associations Between Serum Biomarkers, Social Factors, and ASCVD Scores in African American Men: Interim Analysis from an Ongoing Clinical Trial
Ameena Shafiq1, Rajeet Shrestha1, Carolyn Still2, Christopher Burant2, Jessica Surdam1, Doug Einstadter2, Nicole Fiorelli2, Jacqueline Krehel-Montgomery1, Beth Lute1, Sophia Sundararajan3, MARTHA SAJATOVIC1
1University Hospitals Cleveland Medical Center, 2Case Western Reserve University, 3University Hospitals of Cleveland
Objective:
This study examined associations among Atherosclerotic Cardiovascular Disease (ASCVD) risk scores, serum biomarkers, sociodemographic, and clinical factors in Black men with prior stroke or transient ischemic attack (TIA).
Background:
Stroke remains a leading cause of mortality and disability in the United States, with African American individuals disproportionately affected.
Design/Methods:
This cross-sectional analysis used baseline data from an ongoing 6-month prospective randomized controlled trial (RCT) evaluating the effects of a stroke risk reduction program, TargEted MAnageMent Intervention (TEAM), versus a waitlist control among 160 Black men with a history of stroke or TIA within the past 10 years. Demographic variables included age, education, marital status, living status, and health insurance coverage. Contextual variables included perceived stress (PSS-10), discrimination, and health literacy using validated scales. Stroke risk was estimated using a combination of ASCVD scores as well as serum biomarker and clinical targets per American Heart Association/American Stroke Association guidelines. Associations between sociodemographic, serum biomarker, and ASCVD variables were assessed using point biserial correlations.
Results:
The analyzed sample (n=62) had a mean age of 61.40 years (SD=9.65) and a mean time since stroke/TIA of 32.14 months (SD=27.79). Mean LDL was 81.02 mg/dL (SD=36.90), HbA1c 6.54% (SD=1.25), and BMI 30.50 kg/m² (SD=7.43). Seventy percent were diagnosed with hypertension, and 17.74% were current smokers.
Higher ASCVD scores (≥20%) were associated with older age (r=0.55, p<0.001) and Medicare coverage (r=0.36, p=0.004). Elevated LDL (>70 mg/dL) was associated with not having Medicare and private insurance (r=−0.27, p=0.04). Smoking was related to fewer years of education (r=−0.25, p=0.047) and higher perceived stress (r=0.29, p=0.023). Hypertension (SBP>130 mmHg) was associated with fewer people in the household (r=−0.30, p=0.016).
Conclusions:
Risk of stroke recurrence among Black men is influenced by demographic and contextual factors, underscoring the need for a comprehensive approach to risk assessment and management.
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