Disparities among Asians and native Hawaiians and Pacific Islanders with ischemic stroke.
OBJECTIVE
To evaluate disparities in cardiovascular risk factors among Asians and Native Hawaiians and other Pacific Islanders (NHPI) in Hawaii who are hospitalized with ischemic stroke.


METHODS
We performed a retrospective study on consecutive patients hospitalized for ischemic stroke at a single tertiary center in Honolulu between 2004 and 2010. The prevalence of cardiovascular risk factors was compared for NHPI, Asians, and whites who were hospitalized for ischemic stroke.


RESULTS
A total of 1,921 patients hospitalized for ischemic stroke were studied. NHPI were less likely to be older (odds ratio [OR] 0.95, 95% confidence interval [CI] 0.94-0.96), more likely to be female (OR 1.55, 95% CI 1.07-2.24), and more likely to have diabetes (OR 2.74, 95% CI 1.87-4.00), hypertension (OR 1.98, 95% CI 1.27-3.10), and obesity (OR 1.82, 95% CI 1.25-2.65) than whites. NHPI had higher low-density lipoprotein levels (114 ± 50 mg/dL vs 103 ± 45 mg/dL, p = 0.001) and lower high-density lipoprotein levels (38 ± 11 mg/dL vs 45 ± 15 mg/dL, p < 0.0001) than whites. Compared with Asians, NHPI were less likely to be older (OR 0.95, 95% CI 0.94-0.97) and more likely to have diabetes (OR 1.88, 95% CI 1.35-2.61), previous stroke or TIA (OR 1.57, 95% CI 1.09-2.25), and obesity (OR 6.05, 95% CI 4.31-8.48).


CONCLUSIONS
Asians, NHPI, and whites with ischemic stroke have substantially different cardiovascular risk factors. Targeted secondary prevention will be important in reducing disparities among these racial groups.
Queen's Medical Center, Honolulu, HI, USA. kazuma.nakagawa@hawaii.edu
Kazuma
K
Nakagawa
Matthew A
MA
Koenig
Susan M
SM
Asai
Cherylee W
CW
Chang
Todd B
TB
Seto
D000368:Aged; D044466:Asian People / Q000208:ethnology; D002545:Brain Ischemia / Q000453:epidemiology* / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006254:Hawaii / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000208:ethnology; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000208:ethnology