Incidence and case fatality rates of first-ever stroke in a black Caribbean population: the Barbados Register of Strokes.
OBJECTIVE
Estimation of stroke incidence among black populations outside the USA and the UK has been hampered by the lack of community-based studies. We aimed to document the incidence of first-ever stroke in Barbados, a Caribbean island with a population of 268,000 people.


METHODS
A national community-based prospective register of first-ever strokes, using multiple overlapping sources of notification, was established.


RESULTS
During the first year, 352 patients (95.2% black) were registered, 142 males and 210 females (59.7%), with a mean age of 72.5 years (range 24 to 104; SD 14.8). Cerebral infarction (IS) occurred in 81.8%, intracerebral hemorrhage (ICH) in 11.9%, subarachnoid hemorrhage (SAH) in 2.0%, whereas 4.3% of strokes were unclassified (UC). The crude annual incidence rate for the black population was 1.40 (95% CI: 1.25,1.55) per 1000 (1.35 standardized to the European population) for all strokes, 1.20 (1.07,1.34) for IS, 0.18 (0.12,0.23) for ICH, and 0.03 (0.01,0.05) for SAH. Lacunar infarction (LACI) accounted for 50.7% of IS among the black population, whereas 15.6% and 26.8% were caused by total anterior circulation infarction (TACI) and partial anterior circulation infarction (PACI), respectively. At 7 and 28 days, respectively, case fatality rates for blacks were 13.1% and 27.8% for all strokes, 46.3% and 58.5% for ICH, 7.6% and 21.7% for IS, 32.6% and 65.1% for TACI, and 2.1% and 9.0% for LACI.


CONCLUSIONS
Stroke incidence among the black population of Barbados is lower than among African-origin populations in the USA and UK. Lacunar infarction is the predominant stroke subtype.
Corbin
David O C
DO
Chronic Disease Research Centre/Tropical Medicine Research Institute and School of Clinical Medicine and Research, University of the West Indies, Barbados. doccpec@caribsurf.com
Poddar
Vishal
V
Hennis
Anselm
A
Gaskin
Angela
A
Rambarat
Cecil
C
Wilks
Rainford
R
Wolfe
Charles D A
CD
Fraser
Henry S
HS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001460:Barbados / Q000453:epidemiology; D044383:Black People; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D020521:Stroke / Q000208:ethnology* / Q000401:mortality