Race / Ethnicity and Control of Hypertension after Intracerebral Hemorrhage
Description: Intracerebral hemorrhage (ICH), the most severe form of stroke, is a medical emergency that almost invariably triggers a hospital admission. While 60%-70% of ICH patients survive acute hospitalization, over 60% of them will suffer from deterioration in brain health within 5 years, in the form of recurrent stroke, cognitive decline, depression and apathy, gait impairment, and new-onset epilepsy. This rapid functional decline arises from progression of underlying Cerebral Small Vessel Disease (CSVD), responsible for the acute ICH. Arresting CSVD progression holds the promise of substantially improving brain health-span and quality of life for over 50,000 ICH survivors in the US alone every year. Despite Blood Pressure (BP) control being one of the most potent intervention to slow CSVD progression, over 50% of ICH survivors have uncontrolled hypertension, beginning at 3 months after ICH and persisting indefinitely. As part of previous research efforts the investigate team found that ICH survivors belonging to minority racial / ethnic groups are at even higher risk for uncontrolled HTN, with associated increase in brain health deterioration rates. The proposed clinical research project, entitled “Race / ethnicity and control of hypertension after Intracerebral Hemorrhage” is ultimately aimed at reducing rates of uncontrolled HTN as the highest impact strategy to 1) reduce rates of brain health decline after ICH, but also 2) substantially narrow outcome disparities for minority ICH patients. As part of the proposed project we plan to enroll 200 ICH survivors (60 White, 70 Black and 70 Hispanic) to: 1) determine which modifiable social determinants of health predict rates of uncontrolled HTN at 3 months from ICH (Aim 1); 2) determine whether social network structure and composition predict rates of uncontrolled HTN at 3 months from ICH (Aim 2); 3) combine genetic, neuroimaging, social and clinical information into a prediction tool for BP control at 3 months following ICH, to be deployed during the acute ICH admission. The completion of these analyses will result in identification of specific risk factors linked to inadequate hypertension control after ICH for individual survivors. We will then develop a prediction tool for risk of uncontrolled hypertension among ICH survivors. This tool will be deployed in future studies of targeted interventions to maximize BP control and improve brain health-related outcomes.
Funder: American Heart Association
Amount: $720,300
Funding type: research
Funder scheme: Bugher Foundation Stroke Center
Start date: 2021-01-01
End date: 2024-12-31
Investigators: Jonathan Rosand, Jonathan Rosand
Institution: Massachusetts General Hospital (Mass General)
Funded outputs count: 1
Funder award ID: 814722
OpenAlex ID: G5328523184