BACKGROUND AND PURPOSE: Although the US Black population has a higher incidence of stroke compared with the US White population, few studies have addressed Black-White differences in the contribution of vascular risk factors to the population burden of ischemic stroke in young adults. METHODS: A population-based case-control study of early-onset ischemic stroke, ages 15 to 49 years, was conducted in the Baltimore-Washington DC region between 1992 and 2007. Risk factor data was obtained by in-person interview in both cases and controls. The prevalence, odds ratio, and population-attributable risk percent (PAR%) of smoking, diabetes, and hypertension was determined among Black patients and White patients, stratified by sex. RESULTS: The study included 1044 cases and 1099 controls. Of the cases, 47% were Black patients, 54% were men, and the mean (±SD) age was 41.0 (±6.8) years. For smoking, the population-attributable risk percent were White men 19.7%, White women 32.5%, Black men 10.1%, and Black women 23.8%. For diabetes, the population-attributable risk percent were White men 10.5%, White women 7.4%, Black men 17.2%, and Black women 13.4%. For hypertension, the population-attributable risk percent were White men 17.2%, White women 19.3%, Black men 45.8%, and Black women 26.4%. CONCLUSIONS: Modifiable vascular risk factors account for a large proportion of ischemic stroke in young adults. Cigarette smoking was the strongest contributor to stroke among White patients while hypertension was the strongest contributor to stroke among Black patients. These results support early primary prevention efforts focused on smoking cessation and hypertension detection and treatment.
BACKGROUND AND PURPOSE: Although the US Black population has a higher incidence of stroke compared with the US White population, few studies have addressed Black-White differences in the contribution of vascular risk factors to the population burden of ischemic stroke in young adults. METHODS: A population-based case-control study of early-onset ischemic stroke, ages 15 to 49 years, was conducted in the Baltimore-Washington DC region between 1992 and 2007. Risk factor data was obtained by in-person interview in both cases and controls. The prevalence, odds ratio, and population-attributable risk percent (PAR%) of smoking, diabetes, and hypertension was determined among Black patients and White patients, stratified by sex. RESULTS: The study included 1044 cases and 1099 controls. Of the cases, 47% were Black patients, 54% were men, and the mean (±SD) age was 41.0 (±6.8) years. For smoking, the population-attributable risk percent were White men 19.7%, White women 32.5%, Black men 10.1%, and Black women 23.8%. For diabetes, the population-attributable risk percent were White men 10.5%, White women 7.4%, Black men 17.2%, and Black women 13.4%. For hypertension, the population-attributable risk percent were White men 17.2%, White women 19.3%, Black men 45.8%, and Black women 26.4%. CONCLUSIONS: Modifiable vascular risk factors account for a large proportion of ischemic stroke in young adults. Cigarette smoking was the strongest contributor to stroke among White patients while hypertension was the strongest contributor to stroke among Black patients. These results support early primary prevention efforts focused on smoking cessation and hypertension detection and treatment.
Authors: J Rohr; S Kittner; B Feeser; J R Hebel; M G Whyte; A Weinstein; N Kanarak; D Buchholz; C Earley; C Johnson; R Macko; T Price; M Sloan; B Stern; R Wityk; M Wozniak; R Sherwin Journal: Arch Neurol Date: 1996-07
Authors: Brett M Kissela; Jane C Khoury; Kathleen Alwell; Charles J Moomaw; Daniel Woo; Opeolu Adeoye; Matthew L Flaherty; Pooja Khatri; Simona Ferioli; Felipe De Los Rios La Rosa; Joseph P Broderick; Dawn O Kleindorfer Journal: Neurology Date: 2012-10-10 Impact factor: 9.910
Authors: Ali G Hamedani; John W Cole; Yuching Cheng; Mary J Sparks; Jeffrey R O'Connell; Oscar C Stine; Marcella A Wozniak; Barney J Stern; Braxton D Mitchell; Steven J Kittner Journal: J Stroke Cerebrovasc Dis Date: 2011-11-18 Impact factor: 2.136
Authors: Mercedes R Carnethon; Jia Pu; George Howard; Michelle A Albert; Cheryl A M Anderson; Alain G Bertoni; Mahasin S Mujahid; Latha Palaniappan; Herman A Taylor; Monte Willis; Clyde W Yancy Journal: Circulation Date: 2017-10-23 Impact factor: 29.690