Ethnic disparities in stroke and hypertension among women: the BASIC project.
BACKGROUND
Little data exist on stroke burden in Mexican-American (MA) women. The objective of this study was to characterize the burden of stroke in MA and non-Hispanic white (NHW) women and to compare this burden across ethnic groups.


METHODS
Cases of ischemic stroke and intracerebral hemorrhage among women (January 2000-December 2006) were identified as part of the Brain Attack Surveillance in Corpus Christi (BASIC) Project, a stroke surveillance study in a biethnic Texas community. Cumulative incidence of stroke among women was compared by ethnicity and age. Logistic regression was used to compare risk factors and age-adjusted use of antihypertensives between MA and NHW female stroke cases.


RESULTS
MA women had elevated stroke risk compared with NHW women at younger ages (ages 45-59: relative risk (RR) = 2.00 (95% confidence interval (CI): 1.54-2.58); ages 60-74: RR = 1.57 (95% CI: 1.31-1.87); ages > or =75: RR = 1.13 (95% CI: 0.98-1.29)). Stroke severity and stroke type did not differ between ethnic groups. MA female stroke cases were more likely to have hypertension (odds ratio (OR) = 1.41 (95% CI: 1.11-1.80)), diabetes (OR = 3.54 (95% CI: 2.82-4.45)), and the presence of both risk factors (OR = 3.31 (95% CI: 2.61-4.21)) compared with NHW female stroke cases and were more likely to report use of antihypertensives (OR = 1.51 (95% CI: 1.10-2.06)). There was a trend toward greater hypertension awareness among MA female stroke cases (OR = 1.37 (95% CI: 0.98-1.91)).


CONCLUSIONS
MA women have increased risk of stroke at younger ages compared with NHW women. Reasons for this ethnic disparity, including an increased prevalence of hypertension and diabetes, should be explored.
Lisabeth
Lynda D
LD
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA. llisabeth@umich.edu
Smith
Melinda A
MA
Sánchez
Brisa N
BN
Brown
Devin L
DL
D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002545:Brain Ischemia / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control; D002543:Cerebral Hemorrhage / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control; D048909:Diabetes Complications / Q000208:ethnology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000208:ethnology*; D016015:Logistic Models; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D016387:Women's Health
D000959:Antihypertensive Agents