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Nursing home residents, minorities under-treated for recurrent stroke

k, and Mississippi between 1992 and 1996. Researchers identified 19,051 residents who had been hospitalized in the prior six months for ischemic stroke (clot-caused). Of these residents, 7,053 had other health conditions that warranted the use of anticoagulant therapy.

"The current antiplatelet treatments for stroke prevention in the elderly are aspirin/dipyridamole combination, aspirin, and clopidogrel," Christian said. Warfarin is indicated in people who have had an ischemic stroke and are at an increased risk of clotting.

The researchers found that about 61 percent of Asian/Pacific Islanders did not receive any treatment to prevent recurrent stroke. Likewise, 54 percent of Hispanics, 51 percent of blacks, 46 percent of whites and 42 percent of American Indians were not treated.

In general, Asian/Pacific Islanders received less of any secondary prevention treatment and American Indians received more of any preventive treatment compared to whites.

Most residents 60 percent to 75 percent whose health status indicated the need for a blood thinner did not receive warfarin. Non-white racial groups were less likely to receive the treatment than whites.

"Clearly, interventions are needed to improve and increase the use of treatments for recurrent stroke in all nursing home residents," Christian said. "Not only were important stroke-preventing drugs underused but also most residents who were eligible for anticoagulant therapy in our study did not receive it," she said. "It appears that minority populations in nursing homes are at greater risk for under treatment, which is only partially explained by patient characteristics such as age, gender, physical and cognitive function, or other diseases."

Christian noted that the data is limited to a "snapshot on admission" to a nursing facility and researchers were unable to evaluate whether the observed differences indicate treatment patterns in the nursing home or are
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
9-Oct-2003


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