Abstract DP113: Race and Social Disparities in Blood Pressure Control Before and After Intracerebral Hemorrhage

Background: Blood pressure (BP) control is a crucial component of secondary prevention after intracerebral hemorrhage (ICH), yet long-term control often remains suboptimal, particularly among racial minorities and socioeconomically disadvantaged populations. We compared the relationship between pre- and post-ICH BP control across racial/ethnic and social deprivation groups in the U.S. Methods: We conducted a case-only study within All of Us, an NIH population study aiming to enroll 1 million Americans. We used SNOMED codes to identify ICH survivors from electronic health records. Systolic BP measurements from EHR and baseline study visits were classified as pre-ICH (0–365 days before) and post-ICH (30–365 days after). Area-level socioeconomic status was defined by 3-digit zip-code-based socioeconomic deprivation index (zSDI) tertiles relative to the population. The primary outcome was uncontrolled average systolic BP (≥140 mmHg) at each time point. We used adjusted multivariable logistic regression to estimate the odds of post-ICH uncontrolled BP and causal mediation analysis to identify mediators of identified associations. Results: We included 1,793 ICH survivors with at least one BP measurement pre- or post-ICH (mean age 61.2 years; 48.7% female). Black participants had higher rates of uncontrolled BP than White participants pre-ICH (41.1% vs 22.2%; n=1,453; p