Race-ethnic disparities in the impact of stroke risk factors the Northern Manhattan stroke study

Ralph L. Sacco, Bernadette Boden-Albala, Gregory Abel, I. Feng Lin, Mitchell Elkind, W. Allen Hauser, Myunghee C. Paik, Steven Shea

Research output: Contribution to journalArticle

Abstract

Background and Purpose - Stroke risk factors have been determined in large part through epidemiological studies in white cohorts; as a result, race-ethnic disparities in stroke incidence and mortality rates remained unexplained. The aim in the present study was to compare the prevalence, OR, and etiological fraction (EF) of stroke risk factors among white, blacks, and Caribbean Hispanics living in the same urban community of northern Manhattan. Methods - In this population-based incident case-control study, cases (n=688) of first ischemic stroke were prospectively matched 1:2 by age, sex, and race-ethnicity with community controls (n=1156). Risk factors were determined through in-person assessment. Conditional logistic regression was used to calculate adjusted ORs in each race-ethnic group. Prevalence and multivariate EFs were determined in each race-ethnic group. Results - Hypertension was an independent risk factor for whites (OR 1.8, EF 25%), blacks (OR 2.0, EF 37%), and Caribbean Hispanics (OR 2.1, EF 32%), but greater prevalence led to elevated EFs among blacks and Caribbean Hispanics. Greater prevalence rates of diabetes increased stroke risk in blacks (OR 1.8, EF 14%) and Caribbean Hispanics (OR 2.1 P<0.05, EF 10%) compared with whites (OR 1.0, EF 0%), whereas atrial fibrillation had a greater prevalence and EF for whites (OR 4.4, EF 20%) compared with blacks (OR 1.7, EF 3%) and Caribbean Hispanics (OR 3.0, EF 2%). Coronary artery disease was most important for whites (OR 1.3, EF 16%), followed by Caribbean Hispanics (OR 1.5, EF 6%) and then blacks (OR 1.1, EF 2%). Prevalence of physical inactivity was greater in Caribbean Hispanics, but an elevated EF was found in all groups. Conclusions - The prevalence, OR, and EF for stroke risk factors vary by race-ethnicity. These differences are crucial to the etiology of stroke, as well as to the design and implementation of stroke prevention programs.

Original languageEnglish (US)
Pages (from-to)1725-1731
Number of pages7
JournalStroke
Volume32
Issue number8
StatePublished - 2001

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Hispanic Americans
Stroke
Ethnic Groups
Atrial Fibrillation
Case-Control Studies
Epidemiologic Studies
Coronary Artery Disease
Logistic Models
Hypertension
Mortality
Incidence
Population

Keywords

  • Data interpretation, statistical
  • Epidemiology
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Sacco, R. L., Boden-Albala, B., Abel, G., Lin, I. F., Elkind, M., Hauser, W. A., ... Shea, S. (2001). Race-ethnic disparities in the impact of stroke risk factors the Northern Manhattan stroke study. Stroke, 32(8), 1725-1731.

Race-ethnic disparities in the impact of stroke risk factors the Northern Manhattan stroke study. / Sacco, Ralph L.; Boden-Albala, Bernadette; Abel, Gregory; Lin, I. Feng; Elkind, Mitchell; Hauser, W. Allen; Paik, Myunghee C.; Shea, Steven.

In: Stroke, Vol. 32, No. 8, 2001, p. 1725-1731.

Research output: Contribution to journalArticle

Sacco, RL, Boden-Albala, B, Abel, G, Lin, IF, Elkind, M, Hauser, WA, Paik, MC & Shea, S 2001, 'Race-ethnic disparities in the impact of stroke risk factors the Northern Manhattan stroke study', Stroke, vol. 32, no. 8, pp. 1725-1731.
Sacco, Ralph L. ; Boden-Albala, Bernadette ; Abel, Gregory ; Lin, I. Feng ; Elkind, Mitchell ; Hauser, W. Allen ; Paik, Myunghee C. ; Shea, Steven. / Race-ethnic disparities in the impact of stroke risk factors the Northern Manhattan stroke study. In: Stroke. 2001 ; Vol. 32, No. 8. pp. 1725-1731.
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T1 - Race-ethnic disparities in the impact of stroke risk factors the Northern Manhattan stroke study

AU - Sacco, Ralph L.

AU - Boden-Albala, Bernadette

AU - Abel, Gregory

AU - Lin, I. Feng

AU - Elkind, Mitchell

AU - Hauser, W. Allen

AU - Paik, Myunghee C.

AU - Shea, Steven

PY - 2001

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N2 - Background and Purpose - Stroke risk factors have been determined in large part through epidemiological studies in white cohorts; as a result, race-ethnic disparities in stroke incidence and mortality rates remained unexplained. The aim in the present study was to compare the prevalence, OR, and etiological fraction (EF) of stroke risk factors among white, blacks, and Caribbean Hispanics living in the same urban community of northern Manhattan. Methods - In this population-based incident case-control study, cases (n=688) of first ischemic stroke were prospectively matched 1:2 by age, sex, and race-ethnicity with community controls (n=1156). Risk factors were determined through in-person assessment. Conditional logistic regression was used to calculate adjusted ORs in each race-ethnic group. Prevalence and multivariate EFs were determined in each race-ethnic group. Results - Hypertension was an independent risk factor for whites (OR 1.8, EF 25%), blacks (OR 2.0, EF 37%), and Caribbean Hispanics (OR 2.1, EF 32%), but greater prevalence led to elevated EFs among blacks and Caribbean Hispanics. Greater prevalence rates of diabetes increased stroke risk in blacks (OR 1.8, EF 14%) and Caribbean Hispanics (OR 2.1 P<0.05, EF 10%) compared with whites (OR 1.0, EF 0%), whereas atrial fibrillation had a greater prevalence and EF for whites (OR 4.4, EF 20%) compared with blacks (OR 1.7, EF 3%) and Caribbean Hispanics (OR 3.0, EF 2%). Coronary artery disease was most important for whites (OR 1.3, EF 16%), followed by Caribbean Hispanics (OR 1.5, EF 6%) and then blacks (OR 1.1, EF 2%). Prevalence of physical inactivity was greater in Caribbean Hispanics, but an elevated EF was found in all groups. Conclusions - The prevalence, OR, and EF for stroke risk factors vary by race-ethnicity. These differences are crucial to the etiology of stroke, as well as to the design and implementation of stroke prevention programs.

AB - Background and Purpose - Stroke risk factors have been determined in large part through epidemiological studies in white cohorts; as a result, race-ethnic disparities in stroke incidence and mortality rates remained unexplained. The aim in the present study was to compare the prevalence, OR, and etiological fraction (EF) of stroke risk factors among white, blacks, and Caribbean Hispanics living in the same urban community of northern Manhattan. Methods - In this population-based incident case-control study, cases (n=688) of first ischemic stroke were prospectively matched 1:2 by age, sex, and race-ethnicity with community controls (n=1156). Risk factors were determined through in-person assessment. Conditional logistic regression was used to calculate adjusted ORs in each race-ethnic group. Prevalence and multivariate EFs were determined in each race-ethnic group. Results - Hypertension was an independent risk factor for whites (OR 1.8, EF 25%), blacks (OR 2.0, EF 37%), and Caribbean Hispanics (OR 2.1, EF 32%), but greater prevalence led to elevated EFs among blacks and Caribbean Hispanics. Greater prevalence rates of diabetes increased stroke risk in blacks (OR 1.8, EF 14%) and Caribbean Hispanics (OR 2.1 P<0.05, EF 10%) compared with whites (OR 1.0, EF 0%), whereas atrial fibrillation had a greater prevalence and EF for whites (OR 4.4, EF 20%) compared with blacks (OR 1.7, EF 3%) and Caribbean Hispanics (OR 3.0, EF 2%). Coronary artery disease was most important for whites (OR 1.3, EF 16%), followed by Caribbean Hispanics (OR 1.5, EF 6%) and then blacks (OR 1.1, EF 2%). Prevalence of physical inactivity was greater in Caribbean Hispanics, but an elevated EF was found in all groups. Conclusions - The prevalence, OR, and EF for stroke risk factors vary by race-ethnicity. These differences are crucial to the etiology of stroke, as well as to the design and implementation of stroke prevention programs.

KW - Data interpretation, statistical

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