Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project.
Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects' ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in Mexican Americans and 136/10,000 in non-Hispanic Whites. Mexican Americans had a higher cumulative incidence for ischemic stroke (ages 45-59 years: risk ratio = 2.04, 95% confidence interval: 1.55, 2.69; ages 60-74 years: risk ratio = 1.58, 95% confidence interval: 1.31, 1.91; ages >or=75 years: risk ratio = 1.12, 95% confidence interval: 0.94, 1.32). Intracerebral hemorrhage was more common in Mexican Americans (age-adjusted risk ratio = 1.63, 95% confidence interval: 1.24, 2.16). The subarachnoid hemorrhage age-adjusted risk ratio was 1.57 (95% confidence interval: 0.86, 2.89). Mexican Americans experience a substantially greater ischemic stroke and intracerebral hemorrhage incidence compared with non-Hispanic Whites. As the Mexican-American population grows and ages, measures to target this population for stroke prevention are critical.
Stroke Program, University of Michigan Medical School, Ann Arbor, MI 48109-0316, USA. lmorgens@umich.edu
Lewis B
LB
Morgenstern
Melinda A
MA
Smith
Lynda D
LD
Lisabeth
Jan M H
JM
Risser
Ken
K
Uchino
Nelda
N
Garcia
Paxton J
PJ
Longwell
David A
DA
McFarling
Olubumi
O
Akuwumi
Areej
A
Al-Wabil
Fahmi
F
Al-Senani
Devin L
DL
Brown
Lemuel A
LA
Moyé
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000208:ethnology; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000208:ethnology; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011159:Population Surveillance; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology*; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors