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(Stroke. 2004;35:1254.)
© 2004 American Heart Association, Inc.

Original Contributions

Incidence and Case Fatality Rates of First-Ever Stroke in a Black Caribbean Population

The Barbados Register of Strokes

David O.C. Corbin, FRCP; Vishal Poddar, DM; Anselm Hennis, PhD, MRCP; Angela Gaskin, BASc; Cecil Rambarat, DM; Rainford Wilks, FRCP; Charles D.A. Wolfe, MD Henry S. Fraser, PhD, FRCP

From Chronic Disease Research Centre/Tropical Medicine Research Institute and School of Clinical Medicine and Research (D.O.C.C., V.P., A.H., A.G., C.R., H.S.F.), University of the West Indies, Barbados; Epidemiology Research Unit (R.W.), Tropical Medicine Research Institute, University of the West Indies, Mona, Jamaica; and Department of Public Health Sciences (C.D.A.W.), Guy’s, King’s, and St Thomas’ Hospital School of Medicine, London, UK.

Correspondence to Dr David O.C. Corbin, Chronic Disease Research Centre/Tropical Medicine Research Institute and School of Clinical Medicine and Research, University of the West Indies, Barbados. E-mail doccpec{at}caribsurf.com

Background and Purpose— Estimation of stroke incidence among black populations outside the USA and the UK has been hampered by the lack of community-based studies. We aimed to document the incidence of first-ever stroke in Barbados, a Caribbean island with a population of 268 000 people.

Methods— A national community-based prospective register of first-ever strokes, using multiple overlapping sources of notification, was established.

Results— During the first year, 352 patients (95.2% black) were registered, 142 males and 210 females (59.7%), with a mean age of 72.5 years (range 24 to 104; SD 14.8). Cerebral infarction (IS) occurred in 81.8%, intracerebral hemorrhage (ICH) in 11.9%, subarachnoid hemorrhage (SAH) in 2.0%, whereas 4.3% of strokes were unclassified (UC). The crude annual incidence rate for the black population was 1.40 (95% CI: 1.25,1.55) per 1000 (1.35 standardized to the European population) for all strokes, 1.20 (1.07,1.34) for IS, 0.18 (0.12,0.23) for ICH, and 0.03 (0.01,0.05) for SAH. Lacunar infarction (LACI) accounted for 50.7% of IS among the black population, whereas 15.6% and 26.8% were caused by total anterior circulation infarction (TACI) and partial anterior circulation infarction (PACI), respectively. At 7 and 28 days, respectively, case fatality rates for blacks were 13.1% and 27.8% for all strokes, 46.3% and 58.5% for ICH, 7.6% and 21.7% for IS, 32.6% and 65.1% for TACI, and 2.1% and 9.0% for LACI.

Conclusions— Stroke incidence among the black population of Barbados is lower than among African-origin populations in the USA and UK. Lacunar infarction is the predominant stroke subtype.

Key Words: cerebral infarction • epidemiology • ethnic groups • incidence • stroke

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