Stroke Incidence and Survival in American Indians, Blacks, and Whites: The Strong Heart Study and Atherosclerosis Risk in Communities Study
| Autor: | David M. Vock, Ying Zhang, Wayne D. Rosamond, Clemma J. Muller, W. T. Longstreth, Rebecca F. Gottesman, Alvaro Alonso, Richard F. MacLehose, Jean L. Forster |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Risk Race and Ethnicity Epidemiology 030204 cardiovascular system & hematology White People Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Humans Pooled data Stroke Original Research health disparities Ischemic Stroke Aged business.industry Incidence American Indians Middle Aged blacks Atherosclerosis medicine.disease United States Health equity 3. Good health Black or African American Survival Rate Epidemiologic Studies Atherosclerosis Risk in Communities Indians North American Female Cardiology and Cardiovascular Medicine Stroke incidence business 030217 neurology & neurosurgery Demography |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background American Indians ( AIs ) have high stroke morbidity and mortality. We compared stroke incidence and mortality in AI s, blacks, and whites. Methods and Results Pooled data from 2 cardiovascular disease cohort studies included 3182 AI s from the SHS (Strong Heart Study), aged 45 to 74 years at baseline (1988–1990) and 3765 blacks and 10 413 whites from the ARIC (Atherosclerosis Risk in Communities) Study, aged 45 to 64 years at baseline (1987–1989). Stroke surveillance was based on self‐report, hospital records, and death certificates. We estimated hazard ratios for incident stroke (ischemic and hemorrhagic combined) through 2008, stratified by sex and birth‐year tertile, and relative risk for poststroke mortality. Incident strokes numbered 282 for AI s, 416 for blacks, and 613 for whites. For women and men, stroke incidence among AI s was similar to or lower than blacks and higher than whites. Covariate adjustment resulted in lower hazard ratios for most comparisons, but results for these models were not always statistically significant. After covariate adjustment, AI women and men had higher 30‐day poststroke mortality than blacks (relative risk=2.1 [95% CI=1.0, 3.2] and 2.2 [95% CI=1.3, 3.1], respectively), and whites (relative risk=1.6 [95% CI=0.8, 2.5] and 1.7 [95% CI=1.1, 2.4]), and higher 1‐year mortality (relative risk range=1.3–1.5 for all comparisons). Conclusions Stroke incidence in AI s was lower than for blacks and higher than for whites; differences were larger for blacks and smaller for whites after covariate adjustment. Poststroke mortality was higher in AI s than blacks and whites. |
| Databáze: | OpenAIRE |
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