Ischemic stroke subtype incidence among whites, blacks, and Hispanics

The northern Manhattan study

Halina White, Bernadette Boden-Albala, Cuiling Wang, Mitchell S V Elkind, Tanja Rundek, Clinton B. Wright, Ralph L. Sacco

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1327-1331
Number of pages5
JournalCirculation
Volume111
Issue number10
DOIs
StatePublished - Mar 15 2005

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Hispanic Americans
Stroke
Incidence
Lacunar Stroke
hydroquinone
National Institute of Neurological Disorders and Stroke

Keywords

  • Cerebral infarction
  • Epidemiology
  • Ethnic groups
  • Stroke

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Ischemic stroke subtype incidence among whites, blacks, and Hispanics : The northern Manhattan study. / White, Halina; Boden-Albala, Bernadette; Wang, Cuiling; Elkind, Mitchell S V; Rundek, Tanja; Wright, Clinton B.; Sacco, Ralph L.

In: Circulation, Vol. 111, No. 10, 15.03.2005, p. 1327-1331.

Research output: Contribution to journalArticle

White, Halina ; Boden-Albala, Bernadette ; Wang, Cuiling ; Elkind, Mitchell S V ; Rundek, Tanja ; Wright, Clinton B. ; Sacco, Ralph L. / Ischemic stroke subtype incidence among whites, blacks, and Hispanics : The northern Manhattan study. In: Circulation. 2005 ; Vol. 111, No. 10. pp. 1327-1331.
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abstract = "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.",
keywords = "Cerebral infarction, Epidemiology, Ethnic groups, Stroke",
author = "Halina White and Bernadette Boden-Albala and Cuiling Wang and Elkind, {Mitchell S V} and Tanja Rundek and Wright, {Clinton B.} and Sacco, {Ralph L.}",
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T1 - Ischemic stroke subtype incidence among whites, blacks, and Hispanics

T2 - The northern Manhattan study

AU - White, Halina

AU - Boden-Albala, Bernadette

AU - Wang, Cuiling

AU - Elkind, Mitchell S V

AU - Rundek, Tanja

AU - Wright, Clinton B.

AU - Sacco, Ralph L.

PY - 2005/3/15

Y1 - 2005/3/15

N2 - 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.

AB - 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.

KW - Cerebral infarction

KW - Epidemiology

KW - Ethnic groups

KW - Stroke

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