Abstract TP150: Prevalence of Uncontrolled Vascular Risk Factors Among Stroke and Non-Stroke Adults in the United States: Analysis of National Health and Nutrition Examination Survey (NHANES) 2011–2023

Background: Effective management of vascular risk factors such as hypertension, diabetes, obesity, smoking, and hyperlipidemia is critical for secondary prevention after stroke. However, there is limited national-level evidence on long-term trends in these risk factors, particularly when compared stroke survivors to non-stroke individuals. Previous study showed persistent trend of poorly controlled vascular risk factors among stroke population throughout the years of 2009 – 2020. Here, we present comparison between stroke and non-stroke population during the 2011-2023 period. Methods: We analyzed nationally representative data from NHANES cycles 2011–2023 (N ≈ 34,000 adults). Stroke status was self-reported. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic ≥90 mmHg; high cholesterol as LDL >70 mg/dL, or if unavailable, total cholesterol >200 mg/dL; uncontrolled diabetes as HbA1c >7%; obesity as BMI ≥30 kg/m2; and smoking by self-report. Weighted prevalences with 95% confidence intervals were estimated by stroke status, age (18–50, >50 years), sex, and race/ethnicity (Mexican American, Other Hispanic, Non-Hispanic White, Non-Hispanic Black, Other/Multiracial). Results: Across cycles, stroke survivors consistently had higher prevalences of uncontrolled hypertension (30–50% vs. 15–20% without stroke), diabetes (15–20% vs. <10%), and obesity (35–50% vs. 30–40%). Smoking declined modestly over time but remained comparable in stroke survivors to non-stroke survivors. Non-Hispanic Black stroke survivors exhibited the highest burden of hypertension and obesity. Increasing prevalences of uncontrolled hypertension, obesity, and smoking, were noted in the group of stroke survivors younger than 50 years. Overall, age- and sex-stratified analyses confirmed persistently higher uncontrolled risk factor burden among older adults and racial/ethnic minorities with stroke Conclusions: In 2011–2023, U.S. adults with history of stroke showed persistently higher prevalence of uncontrolled vascular risk factors compared with those without stroke history. In addition, differences were observed across ethnic groups. These findings underscore the need for equitable, targeted strategies to improve secondary prevention and risk factor control in stroke survivors