The role of stroke risk factors in the prevalence of stroke symptoms among Hispanic/Latinx Adults

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PROJECT SUMMARY/ABSTRACT Hispanic/Latinx adults exhibit a significantly greater incidence of total stroke, younger age at stroke mortality, and worse neurologic, cognitive, and functional outcomes post-stroke than Whites. Identifying Hispanic/Latinx adults at high risk of stroke is critical to eliminating racial/ethnic inequities in stroke and long-term stroke outcomes. The Questionnaire for Verifying Stroke-Free Status is as a novel and validated screening tool used to identify individuals at a high risk of incident stroke through the self-report of stroke symptoms (sudden onset of unilateral weakness, unilateral numbness, loss of vision, loss of half-vision, inability to understand, and inability to communicate). Endorsement of at least one stroke symptom is predictive of total stroke incidence irrespective of other stroke risk factors, based on data from clinical and epidemiologic studies. However, current research has focused exclusively on non-Hispanic Black and White adults. Due to variability in the prevalence of stroke risk factors and social determinants of health among Hispanic/Latinx adults compared to other racial/ethnic groups, the relationship between stroke risk factors and stroke symptoms among and between Hispanic/Latinx adults is uncertain. This innovative project will address the critical gaps in our knowledge of the relationship between stroke risk factors and stroke symptoms among Hispanic/Latinx adults by (1) assessing the association between hypertension, diabetes (severity and clinical control) and stroke symptoms and variability across heritage group and (2) determining the clinical, socio-economic and socio-cultural factors explaining differences in stroke symptoms across Hispanic/Latinx heritage groups. These aims will be accomplished by utilizing previously collected data on stroke symptoms among participants of Hispanic Community Health Study/Study of Latinos (HCHS/SOL) as an extension of the Principal Investigator's National Heart, Lung and Blood Institute (NHLBI) funded K01 award (HL124391). The HCHS/SOL is a prospective NIH-funded cohort of over 16,000 Hispanic/Latinx adults of heterogenous heritage from four geographic regions. This application will also contribute to the NHLBI's strategic objectives to address disparities in health by filling crucial gaps in our understanding of stroke risk among and between Hispanic/Latinx adults and by promoting biomedical workforce diversity through the support of the applicant, a Latina investigator, transitioning toward independence. These data will be used to inform future R01 applications to implement culturally tailored messaging and screening interventions to identify Hispanic/Latinx adults at high risk of stroke.