From the Division of Neurology, Barrow Neurological Institute, Phoenix,
Arizona.
Correspondence to James L. Frey, MD, 222 West Thomas Rd, Ste 415, Phoenix, AZ 85013.
Background and
Purpose—Identification of specific features of stroke in minority
populations should lead to more effectively focused treatment and
prevention.
Methods—We examined 1290 white (WHI), 242 Hispanic (HIS), 83
Native American (NA), and 101 other stroke and transient
ischemic attack (TIA) patients hospitalized at the Barrow
Neurological Institute from 1990 through 1996.
Results—Chi-square analysis detected significant
(P<.05) differences as follows: (1) Stroke types— lacunes
more prevalent in NA than WHI and HIS (30% versus 16% and 15%);
cardioembolic more prevalent in WHI than HIS (16% versus 9%, NA
14%); hemorrhages more prevalent in HIS than WHI and NA (48%
versus 37% and 27%); (2) Risk factors— hypertension more prevalent
in HIS than WHI (72% versus 66%; NA 71%); diabetes more prevalent in
NA than HIS and WHI (62% versus 36% and 17%); cigarette smoking more
prevalent in WHI than HIS and NA (61% versus 46% and 41%); cardiac
disease more prevalent in WHI than HIS (34% versus 24%; NA 27%);
heavier alcohol intake in NA than HIS than WHI (43% versus 24% versus
17%). There were no significant outcome differences between races for
any stroke type. ANOVA detected significantly lower mean age at stroke
onset in NA than HIS than WHI (56 versus 61 versus 69 years).
Conclusions—There are significant differences in prevalence of
risk factors and stroke types between WHI, HIS, and NA in our
hospital-based population. Although the three races appear to respond
to risk factors similarly, Hispanics may be especially susceptible to
hemorrhage. Further evaluation of these observations in
community-based studies will be important.
© 1998 American Heart Association, Inc.
Original Contributions
Differences in Stroke Between White, Hispanic, and Native American Patients
The Barrow Neurological Institute Stroke Database
Key Words: epidemiology • Hispanic Americans • Indians, North American • racial differences • stroke
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