Abstract Body: Background: Existing data indicate recent increases in the prevalence of stroke and relevant risk factors as well as predicted continued increases in coming years. Our objective was to evaluate population-based data on the prevalence of stroke risk factors and related medication use by sex through 2021.

Methods: Data on the prevalence of stroke risk factors and medication use were taken from our general population random-digit dial survey conducted during 6 time periods: 1995, 2000, 2005, 2011, 2016, and 2021. Due to survey sampling design, survey participants' characteristics (sex, race, age) are representative of the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) ischemic stroke study population. We examined the proportion of females vs. males who reported having hypertension (HTN), hyperlipidemia (HL), diabetes (DM), and current smoking and who reported using antihypertensive medications, lipid-lowering agents, aspirin, and anticoagulants (AC).

Results: Over 6 study periods, a total of 12,336 participants completed the survey; 59% were female, and 25% were Black. Mean age of participants (in years) went up over time in both females (64 [SD 16.3] in 1995 to 69 [SD 16.4] in 2021) and males (61 [SD 15.7] in 1995 to 67 [SD 16.8] in 2021), p_trend <0.0001 for both). Prevalence of HTN, DM, and HL increased over the 6 study periods in both females and males, and current smoking decreased (Figure 1, all p_trend <0.0001). All preventive medications (anti-hypertensives, lipid-lowering, aspirin, and AC) assessed increased over time (Figure 2). In 2021, similar proportions of females vs. males had HTN, DM, DL, and were current smokers (p>0.05). Further, similar proportions of females vs. males were on antihypertensives, lipid-lowering medications, and aspirin, though more men than women were on AC (15% vs. 10%, p<0.05).

Conclusions: In this population-based survey of residents of a 5-county region of southern Ohio and northern Kentucky, the reported prevalence of stroke risk factors increased over a 26-year period in both females and males, as did use of medications used to modify these risk factors. An increasing burden of cardiometabolic risk factors may increase stroke event rates in the future and points to the need for improved primordial prevention.