Literature DB >> 24261746

A comparative analysis of risk factors for stroke in blacks and whites: the Atherosclerosis Risk in Communities study.

Rachel R Huxley1, Elizabeth J Bell, Pamela L Lutsey, Cheryl Bushnell, Eyal Shahar, Wayne Rosamond, Rebecca Gottesman, Aaron Folsom.   

Abstract

OBJECTIVE: Previous studies have speculated that the higher stroke incidence rate (IR) in blacks compared with whites may be due, in part, to stroke risk factors exerting a more adverse effect among blacks than whites. To determine whether such racial differences exist we compared the prospective associations between novel, traditional, and emerging stroke risk factors in blacks and whites.
DESIGN: Baseline characteristics on risk factor levels were obtained on 15,407 participants from the Atherosclerosis Risk in Communities Study. Stroke incidence was ascertained from 1987 to 2008. Adjusted Cox proportional hazard models were used to compute hazard ratios (HRs) and their 95% confidence intervals (CIs) for stroke in relation to stroke risk factor levels stratified by race.
RESULTS: During follow-up, 988 stroke events occurred: blacks had higher stroke incident rates compared with whites with the greatest difference in those aged <60 years: 4.34, 3.24, 1.20, and 0.84 per 1000 person-years, in black men, black women, white men, and white women, respectively. Associations between risk factors with incident stroke were similar in blacks and whites excluding diabetes which was more strongly associated with the risk of stroke in blacks than in whites: HR 2.54 (95% CI: 2.03-3.18) versus 1.74 (1.37-2.21), respectively; p for race interaction=0.02.
CONCLUSIONS: At all ages, blacks are at a considerably higher risk of incident stroke compared with whites, although the effect is most marked in younger age groups. This is most likely due to blacks having a greater burden of stroke risk factors rather than there being any substantial race differences in the associations between risk factors and stroke outcomes.

Entities:  

Keywords:  racial differences; risk factors; stroke

Mesh:

Year:  2013        PMID: 24261746      PMCID: PMC4029919          DOI: 10.1080/13557858.2013.857765

Source DB:  PubMed          Journal:  Ethn Health        ISSN: 1355-7858            Impact factor:   2.772


  32 in total

1.  Cerebrovascular disease in the bi-racial population of Evans County, Georgia.

Authors:  A Heyman; H R Karp; S Heyden; A Bartel; J C Cassel; H A Tyroler; J Cornoni; C G Hames; W Stuart
Journal:  Stroke       Date:  1971 Nov-Dec       Impact factor: 7.914

2.  Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging.

Authors:  P Pignoli; E Tremoli; A Poli; P Oreste; R Paoletti
Journal:  Circulation       Date:  1986-12       Impact factor: 29.690

3.  Black-white differences in stroke incidence in a national sample. The contribution of hypertension and diabetes mellitus.

Authors:  S J Kittner; L R White; K G Losonczy; P A Wolf; J R Hebel
Journal:  JAMA       Date:  1990-09-12       Impact factor: 56.272

4.  Race-ethnic disparities in the impact of stroke risk factors: the northern Manhattan stroke study.

Authors:  R L Sacco; B Boden-Albala; G Abel; I F Lin; M Elkind; W A Hauser; M C Paik; S Shea
Journal:  Stroke       Date:  2001-08       Impact factor: 7.914

Review 5.  Risk factors for stroke in blacks: a critical review.

Authors:  R F Gillum
Journal:  Am J Epidemiol       Date:  1999-12-15       Impact factor: 4.897

6.  Prediction of ischemic stroke risk in the Atherosclerosis Risk in Communities Study.

Authors:  Lloyd E Chambless; Gerardo Heiss; Eyal Shahar; Mary Jo Earp; James Toole
Journal:  Am J Epidemiol       Date:  2004-08-01       Impact factor: 4.897

7.  Race-ethnic differences in stroke risk factors among hospitalized patients with cerebral infarction: the Northern Manhattan Stroke Study.

Authors:  R L Sacco; D E Kargman; M C Zamanillo
Journal:  Neurology       Date:  1995-04       Impact factor: 9.910

8.  The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators.

Authors: 
Journal:  Am J Epidemiol       Date:  1989-04       Impact factor: 4.897

9.  Total and cardiovascular mortality in relation to cigarette smoking, serum cholesterol concentration, and diastolic blood pressure among black and white males followed up for five years.

Authors:  J D Neaton; L H Kuller; D Wentworth; N O Borhani
Journal:  Am Heart J       Date:  1984-09       Impact factor: 4.749

10.  Determinants of black-white differences in the risk of cerebral infarction. The National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.

Authors:  W H Giles; S J Kittner; J R Hebel; K G Losonczy; R W Sherwin
Journal:  Arch Intern Med       Date:  1995-06-26
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  5 in total

1.  Does the Association of Diabetes With Stroke Risk Differ by Age, Race, and Sex? Results From the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Authors:  Gargya Malla; D Leann Long; Suzanne E Judd; Marguerite R Irvin; Brett M Kissela; Daniel T Lackland; Monika M Safford; Deborah A Levine; Virginia J Howard; George Howard; J David Rhodes; Jenifer H Voeks; Dawn O Kleindorfer; Aaron Anderson; James F Meschia; April P Carson
Journal:  Diabetes Care       Date:  2019-08-07       Impact factor: 19.112

2.  Characteristics and Cardiovascular Disease Event Rates among African Americans and Whites Who Meet the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) Trial Inclusion Criteria.

Authors:  Lisandro D Colantonio; Keri L Monda; Robert S Rosenson; Todd M Brown; Katherine E Mues; George Howard; Monika M Safford; Larisa Yedigarova; Michael E Farkouh; Paul Muntner
Journal:  Cardiovasc Drugs Ther       Date:  2019-04       Impact factor: 3.727

3.  Brain Aging in African-Americans: The Atherosclerosis Risk in Communities (ARIC) Experience.

Authors:  Rebecca F Gottesman; Myriam Fornage; David S Knopman; Thomas H Mosley
Journal:  Curr Alzheimer Res       Date:  2015       Impact factor: 3.498

4.  Associations of Brain Structure With Adiposity and Changes in Adiposity in a Middle-Aged and Older Biracial Population.

Authors:  B Gwen Windham; Seth T Lirette; Myriam Fornage; Emelia J Benjamin; Kirby G Parker; Stephen T Turner; Clifford R Jack; Michael E Griswold; Thomas H Mosley
Journal:  J Gerontol A Biol Sci Med Sci       Date:  2017-06-01       Impact factor: 6.053

5.  Associations of Multimorbid Medical Conditions and Health-Related Quality of Life Among Older African American Men.

Authors:  Olivio J Clay; Martinique Perkins; Gail Wallace; Michael Crowe; Patricia Sawyer; Cynthia J Brown
Journal:  J Gerontol B Psychol Sci Soc Sci       Date:  2018-01-11       Impact factor: 4.077

  5 in total

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