Stroke in the young in the northern Manhattan stroke study.
OBJECTIVE
Stroke and stroke subtype incidence in young black and Hispanic populations have not been well studied. The purpose of this study was to determine stroke incidence rates in these populations and to compare rates among various race-ethnic, sex, and age groups.


METHODS
A population-based incidence study identified all cases of first stroke in Northern Manhattan from 1993 to 1997. Stroke and stroke subtype incidence rates were calculated for younger (20 to 44 years of age) and older (>/=45 years of age) adults. The relative risk (RR) of stroke in blacks and Hispanics compared with whites was calculated. Stroke subtypes, infarct subtypes, and case fatality rates were compared in the young and old and in different race-ethnic groups and sexes.


RESULTS
Over 4 years, 74 cases of first stroke in young patients were discovered (47% women, 12% black, 80% Hispanic, 8% white). The stroke incidence rates (cases per 100 000 persons per year) in the young were 23 overall, 10 for infarct, 7 for intracerebral hemorrhage (ICH), and 6 for subarachnoid hemorrhage. The RR of stroke in the young was greatest for blacks (2.4; 95% CI, 0.8 to 6.7) and Hispanics (2.5; 95% CI, 1.1 to 5.8) compared with whites. ICH was more frequent in men with a RR of 3.7 (95% CI, 1.4 to 10.1). Case fatality rates at 30 days were higher in blacks (38%) and Hispanics (16%) compared with whites (0%).


CONCLUSIONS
Young blacks and Hispanics have greater stroke incidences than young whites.
Jacobs
Bradley S
BS
Wayne State University/Detroit Medical Center Comprehensive Stroke Program, Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA. bjacobs@med.wayne.edu
Boden-Albala
Bernadette
B
Lin
I-Feng
IF
Sacco
Ralph L
RL
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D002544:Cerebral Infarction / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology / Q000208:ethnology; D016017:Odds Ratio; D012306:Risk; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D044465:White People / Q000706:statistics & numerical data