Five-year outcome of a stroke cohort in Martinique, French West Indies: Etude Réalisée en Martinique et Centrée sur l'Incidence des Accidents vasculaires cérebraux, Part 2.
OBJECTIVE
Limited information exists on stroke among black populations outside the United States and United Kingdom. Part 1 of the Etude Réalisée en Martinique et Centrée sur l'Incidence des Accidents vasculaires cérebraux (ERMANCIA) provided strong epidemiologic data on the incidence of first-ever stroke in a black Caribbean population and showed a 40% greater incidence of stroke in Martinique than in continental France. In ERMANCIA part 2, we evaluated the long-term outcomes of our cohort.


METHODS
Survivors of a first stroke from this prospective, community-based, stroke incidence study were reassessed at 5 years according to standardized procedures and criteria, including the modified Rankin scale, Barthel Index, Montgomery-Asberg Depression-Rating Scale, Mini-Mental State Examination, treatment compliance, and blood pressure control.


RESULTS
Of the 293 survivors of the original 580 (50.5%) patients who were still alive 5 years after stroke, 262 (89.4%) were assessed. Among these survivors, 66.4% were functionally independent and 43% were completely autonomous for activities of daily living, but 25.8% were depressed and 58.9% were cognitively impaired. Only 50 of 170 (29.4%) of the hypertensive patients achieved their target blood pressure.


CONCLUSIONS
These results highlight the very poor blood pressure control and the very high rate of cognitive impairment in Martinican patients after stroke. As a consequence, a poststroke prevention network was established in Martinique.
Chausson
Nicolas
N
Department of Neurology, University Hospital of Fort-de-France, Martinique, French West Indies. nicolaschausson@hotmail.com
Olindo
Stéphane
S
Cabre
Philippe
P
Saint-Vil
Martine
M
Smadja
Didier
D
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology; D003863:Depression / Q000209:etiology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000150:complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D017741:Survivors; D016896:Treatment Outcome