Abstract WP201: Racial Disparities among Incident Ischemic Stroke Cases in the District of Columbia: the ASPIRE Study
Background: Racial disparities in ischemic stroke incidence have been found in previous studies with blacks having higher rates compared to whites. Recent data has suggested a decrease in stroke incidence but not necessarily a decrease in race differentials. We sought to document incidence of ischemic stroke and explore race-ethnic differentials in the urban, Washington, DC metro area.
METHODS: ASPIRE is a multi-dimensional intervention with a three-pronged approach (community, hospital, EMS) to acute stroke preparedness targeted to increase IV tPA utilization in underserved black communities in DC. Using a comprehensive active and passive surveillance strategy including stroke admission alerts, stroke champions, admission/discharge data and chart review, the ASPIRE research team prospectively identified all hospitalized incident ischemic strokes between January 2008 and July 2012. Direct age-adjusted rates were estimated using age specific proportions from the 2010 census of the DC population for each sex, gender and race subgroup.
RESULTS: Over 4.5 years, we captured 691 incident ischemic strokes: mean age 67 yrs +/- 15 yrs; 79% were blacks; and 55% females. Over 45% of the incident ischemic strokes occurred in black-females. Risk factors including hypertension (79%), diabetes (39%), and current smoking (28%) were significantly greater for blacks than whites. The age-adjusted average annual incidence rate per 100,000 was 226 overall: 171 for blacks, 45 for whites; 65 for black-males; 19 for white-males; 106 for black-females; and 26 for white-females
CONCLUSION: We report significant racial disparities in the incidence of hospitalized ischemic in the DC metro area despite potential undercounting of non-hospitalized stroke cases, and potential competing mortalities in black men (ie. ICH, homicide, AIDS). This continued excess burden of ischemic stroke, particularly in black females, highlights the ongoing importance of projects such as ASPIRE to continue education and preparedness among those with increased risk.
- © 2012 by American Heart Association, Inc.