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Health Disparities
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Yvonne Commodore-Mensah, Ruth-Alma Turkson-Ocran, Oluwabunmi Ogungbe, Samuel Byiringiro, Diana-Lyn Baptiste
Health disparities have been observed by geographical location (region, state, urban, rural) and zip code (Institute of Medicine, 2002). For example, regardless of race/ethnicity, persons in the Southeastern US have a higher prevalence of stroke and death from hypertension than other US regions (Howard et al., 2007). This area is known as the Stroke Belt. Within this area lies the Stroke Buckle, a region along the coastal “low country” plains of the Carolinas and Georgia, which has even higher stroke rates (Howard & Howard, 2020).
Tennessee case study
Published in Edward M. Rafalski, Ross M. Mullner, Healthcare Analytics, 2022
Cori Cohen Grant, David Schwartz, Arash Shaban-Nejado
The population in Shelby County suffers greatly from numerous health problems including a high prevalence of heart disease (177/1,00,000) obesity (33%), smoking (38%), and diabetes (33%). Mortality rates from diabetes are 16% for Whites and 44% Blacks [21]. Due to the high prevalence of these risk factors, Shelby County is said to lie within the U.S. “stroke belt”[22, 23], “diabetes belt” [24], and “Tobacco Nation”[25].
Systemic hypertension in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Wilbert S. Aronow, William H. Frishman
The REasons for Geographic and Racial Differences in Stroke (REGARDS) study is an observational study of the incidence of stroke in persons living in the stroke belt and stroke buckle regions of the United States (153). In this study, 4181 persons aged 55–64 years, 3737 persons aged 65–74 years, and 1839 patients aged 75 years and older (mean age 79.3 years) were receiving treatment with antihypertensive drugs. The median follow-up was 4.5 years for cardiovascular disease (coronary heart disease or stroke) and coronary heart disease, 5.7 years for stroke, and 6.0 years for all-cause death. We concluded from this study that in persons aged 55 years and older treated with antihypertensive drugs, a systolic BP between 120 and 139 mmHg was significantly associated with a lower risk for cardiovascular events and for all-cause death (153). The optimal diastolic BP in this study was 70–90 mmHg.
Managing the elderly patient with hypertension: current strategies, challenges, and considerations
Published in Expert Review of Cardiovascular Therapy, 2020
The REasons for Geographic and Racial Differences in Stroke (REGARDS) study is an observational study of the incidence of stroke in persons living in the stroke belt and stroke buckle regions of the United States [13]. In this study, 4,181 persons were aged 55–64 years, 3,737 persons were aged 65–74 years, and 1,839 patients were aged 75 years and older (mean age 79.3 years) receiving treatment with antihypertensive drugs. Median follow-up was 4.5 years for cardiovascular disease (coronary heart disease or stroke) and coronary heart disease, 5.7 years for stroke, and 6.0 years for all-cause death. This study concluded that in persons aged 55 years and older treated with antihypertensive drugs, a systolic blood pressure between 120 and 139 mm Hg was significantly associated with a decreased risk for cardiovascular events and for all-cause death [13]. The optimal diastolic blood pressure in this study was 70 to 90 mm Hg [14].
Accuracy of Prehospital Identification of Stroke in a Large Stroke Belt Municipality
Published in Prehospital Emergency Care, 2018
Nee-Kofi Mould-Millman, Halea Meese, Ibthial Alattas, Moges Ido, Iasson Yi, Tolulope Oyewumi, Michael Colman, Michael Frankel, Arthur Yancey
Few methodologically rigorous, large-sample, outcomes-based, published EMS stroke studies have evaluated the accuracy of prehospital stroke identification in the “stroke belt” population. The stroke belt is defined as 11 contiguous states in the southeast United States, which were distinguished in the early 1960s by observed higher death rates from stroke (12, 13). Most EMS systems are unable to determine EMD or paramedic accuracy in identifying stroke patients, or the outcomes of patients with strokes that were not detected in the field by EMS providers (i.e., false negative rates) (9). The absence of such data hinders the ability to benchmark the effect of EMS intervention on evaluation and outcomes for strokes.
Liquid biopsy markers for stroke diagnosis
Published in Expert Review of Molecular Diagnostics, 2020
Harshani Wijerathne, Malgorzata A. Witek, Alison E. Baird, Steven A. Soper
Medical conditions such as high blood pressure, high cholesterol, heart disease, diabetes, and obesity can increase stroke risk. Sociodemographic and geographic disparities persist where the incidence of stroke is significantly higher. The geographical distribution of stroke events in the US shows a ‘Stroke Belt’, an area in the Southeastern US with the highest rate of stroke mortality. Place of residence likely contributes to the development of stroke risk factors such as norms influencing dietary patterns, exposure to life stressors, access to healthcare, and lifestyle choices including lack of regular physical activity and the highest prevalence of cardiovascular risk factors [4].