Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study.
BACKGROUND
Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community.


RESULTS
A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100,000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09).


CONCLUSIONS
The high ischemic stroke incidence among blacks and Hispanics compared with whites is due to higher rates of all ischemic stroke subtypes.
White
Halina
H
Department of Neurology, College of Physicians and Surgeons, USA.
Boden-Albala
Bernadette
B
Wang
Cuiling
C
Elkind
Mitchell S V
MS
Rundek
Tanja
T
Wright
Clinton B
CB
Sacco
Ralph L
RL
D001741:Black or African American / Q000706:statistics & numerical data*; D017668:Age of Onset; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000208:ethnology; D020520:Brain Infarction / Q000208:ethnology; D002545:Brain Ischemia / Q000145:classification / Q000208:ethnology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D002537:Intracranial Arteriosclerosis / Q000208:ethnology; D020766:Intracranial Embolism / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data*