doi: 10.1161/01.CIR.0000157736.19739.D0
(Circulation. 2005;111:1327-1331.)
© 2005 American Heart Association, Inc.
Stroke |
Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics
The Northern Manhattan Study
From the Department of Neurology, College of Physicians and Surgeons (H.W., B.B.-A., M.S.V.E., C.B.W., T.R., R.L.S.), Gertrude H. Sergievsky Center (R.L.S., M.S.V.E.), Department of Epidemiology (R.L.S.), Department of Sociomedical Science (B.B.-A.), and Department of Biostatistics (C.W.), Joseph Mailman School of Public Health, Columbia University.
Correspondence to Ralph L. Sacco, MD, MS, Neurological Institute, Room 640, 710 W 168th St, New York, NY, 10032. E-mail rls1{at}columbia.edu
Received October 9, 2004; revision received December 17, 2004; accepted December 29, 2004.
Background— Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community.
Methods and Results— A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100 000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09).
Conclusions— The high ischemic stroke incidence among blacks and Hispanics compared with whites is due to higher rates of all ischemic stroke subtypes.
Key Words: cerebral infarction • epidemiology • ethnic groups • stroke
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