Rural Residence and Antihypertensive Medication Use in US Stroke Survivors

Phoebe M. Tran, Lam T. Tran, Cenjing Zhu, Tiffany Chang, Inna P. Powers, Larry B. Goldstein, Judith H. Lichtman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


BACKGROUND: Relatively greater increases in hypertension prevalence among US rural residents may contribute to geographic disparities in recurrent stroke. There is limited US information on poststroke antihypertensive medication use by rural/urban residence. We assessed antihypertensive use and lifestyle characteristics for US rural compared with urban stroke survivors and residence-based trends in use between 2005 and 2019. METHODS AND RESULTS: US stroke survivors with hypertension were identified in the 2005 to 2019 national Behavioral Risk Factor Surveillance System surveys. We ascertained the survey-weighted prevalence of reported antihypertensive use and lifestyle characteristics (ie, physical activity, diabetes, cholesterol, body mass index, and smoking) among respondents with hypertension in odd years over this period by rural/urban residence. Separate trend analyses were used to detect changes in use over time. Survey-weighted logistic regression was used to calculate unadjusted and adjusted (sociodemographic and lifestyle factors) odds ratios for antihypertensive use by year. Our study included 82 175 individuals (36.4% rural residents). Lifestyle characteristics were similar between rural and urban residents except for higher smoking prevalence among rural residents. Antihypertensive use was similar between rural and urban stroke survivors in unadjusted and adjusted analyses (>90% in both populations). Trend analyses showed a small but significant increase in antihypertensive use over time among urban (P=0.033) but not rural stroke survivors (P=0.587). CONCLUSIONS: Our findings indicate that poststroke antihypertensive use is comparable in rural and urban residents with a reported history of hypertension, but additional work is merited to identify reasons for a trend for increased use of these drugs among urban residents.

Original languageEnglish
Article numbere026678
JournalJournal of the American Heart Association
Issue number15
StatePublished - 2022

Bibliographical note

Funding Information:
This study was funded in part by grants R01AG056628 and F31AG06772001 from the National Institute on Aging and grant T32HG00004026 from the National Human Genome Research Institute. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© 2022 The Authors.


  • hypertension, secondary prevention
  • rural/urban
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Rural Residence and Antihypertensive Medication Use in US Stroke Survivors'. Together they form a unique fingerprint.

Cite this