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(Stroke. 1997;28:15-18.)
© 1997 American Heart Association, Inc.

Articles

African Americans and Women Have the Highest Stroke Mortality in Texas

Lewis B. Morgenstern, MD; William D. Spears, PhD; David C. Goff, Jr, MD, PhD; James C. Grotta, MD Milton Z. Nichaman, MD, ScD

the Department of Neurology (L.B.M., J.C.G.) and the Epidemiology Research Program, School of Public Health, (W.D.S., D.C.G., M.Z.N.), University of Texas, Houston.

Correspondence to Lewis B. Morgenstern, MD, Department of Neurology, University of Texas at Houston, 6431 Fannin, 7.004, Houston, TX 77030.

Background and Purpose Hispanic American (HA), African American (AA), and non-Hispanic white (NHW) populations are well represented in Texas. The Texas HA population is 95% Mexican American, affording comparison with other Hispanic populations. From risk factor profiles we expected stroke mortality to be highest in AAs and HAs. We also expected stroke mortality to be considerably higher for men than for women based on previous data.

Methods We used International Classification of Diseases, 9th Revision, codes 430 to 438 to search Texas vital statistics data for the 5-year period from 1988 through 1992. Race/ethnic differences are presented in age- and sex-specific format to avoid masking the important interaction of age and sex with stroke mortality.

Results Women constituted 61% of the 40 346 stroke deaths in Texas during this period. The ratio of stroke deaths for women versus men approximates the ratio of women to men in the population. AAs had a threefold to fourfold increased stroke mortality relative to NHWs at young ages. At older ages, when stroke mortality is the highest, the stroke mortality rate in NHWs approached the stroke mortality rate of AAs. HAs had a significantly higher rate of stroke mortality at younger ages relative to NHWs but a significantly lower rate at older ages.

Conclusions Measures to prevent stroke mortality should emphasize its predilection for young AAs and women. A rigorous surveillance project is needed to determine whether stroke mortality is underestimated in the HA population.

Key Words: blacks • epidemiology • Hispanic Americans • racial differences • women

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