ABSTRACT NUMBER: ESOC2026A814 SOCIAL DETERMINANTS OF HEALTH AND BLOOD PRESSURE CONTROL AFTER INTRACEREBRAL HEMORRHAGE

Abstract Background and aims Uncontrolled blood pressure (BP) is the most potent modifiable risk factor for secondary events after spontaneous, non-traumatic intracerebral hemorrhage (ICH), yet fewer than half of ICH survivors achieve BP control three months post-ICH. We hypothesize that adverse social determinants of health (SDOH) contribute to uncontrolled BP after ICH. Methods ICH survivors were prospectively enrolled across eight US medical centers. Participants completed home BP measurements and telephone follow-up every three months post-ICH. Five SDOH aligned with the Healthy People 2030 SDOH domains were measured and dichotomized: education, employment, social support, insurance, and social deprivation index (SDI). To maximize statistical power, we constructed a 5-point composite score as the weighted sum of individual SDOH, with weights based on the absolute values of adjusted logistic regression coefficients. We tested individual SDOH and the composite score for association with uncontrolled BP (≥130/80 mmHg) using logistic regression models adjusted for age, sex, and time from ICH. Results We included 107 ICH survivors (mean age: 62 years, 33% female), of whom 54 (51%) had uncontrolled BP at follow-up (median [IQR]: 98 [91-128] days). Evaluated separately, unemployment (OR=3.75 [95% CI=1.19, 11.80]; p=0.02) and high SDI (2.56 [1.10, 5.95]; p=0.02) were associated with uncontrolled BP. In the composite SDOH score, each 1-point increase was associated with higher risk of uncontrolled BP (1.84 [1.24, 2.72]; p=0.003). Conclusions In this prospective cohort of ICH survivors, SDOH were associated with uncontrolled BP three months post-ICH. Further research is warranted into secondary prevention strategies targeting ICH survivors with adverse social risk profiles. Conflict of interest Jonathan Rosand declares grants from US National Institutes of Health and American Heart Association. Christopher Anderson discloses grants from US National Institutes of Health, American Heart Association, and Massachusetts General Hospital, sponsored research support from Bayer AG, and consulting for ApoPharma and MPM BioImpact. Evy Reinders: Nothing to disclose. Sanjula Singh: nothing to disclose. Matthew Bevers: nothing to disclose. Daniel Daneshvar: nothing to disclose. Hannah Breit: nothing to disclose. Guido Falcone: nothing to disclose. Anjail Sharrief: nothing to disclose. Gunjan Parikh: nothing to disclose. Kazuma Nakagawa: nothing to disclose. Lesli Skolarus: nothing to disclose. Amar Dhand: nothing to disclose. Carl Langefeld: nothing to disclose. Amytis Towfighi: nothing to disclose. Figure 1 - belongs to Results