Abstract

Introduction: In the U.S., Hispanic/Latino adults experience a higher incidence of stroke overall and at younger ages than non-Hispanic White adults. However, given the diversity of U.S. Hispanic/Latinos, understanding heterogeneity in stroke symptom recognition by background is critical to prevention. Methods: The primary outcome was self-reported stroke symptoms over the past year using the validated and telephone-administered Questionnaire for Verifying Stroke Free Status of 8,235 stroke free HCHS/SOL participants in 2017 (mean age=49 + 0.25). Stroke risk factors were collected at baseline (2008-2011) using standardized measurements and validated questionnaires. Stroke risk factors were defined as clinical factors (blood pressure, diabetes, anthropometrics, family history of cardiovascular disease [CVD], smoking, and alcohol consumption), medication use (aspirin, statin, and antihypertensive medication use), and self-reported sociodemographic factors (heritage, sex, education, and years in the mainland US). The prevalence of stroke symptoms and 95% confidence intervals (CI) were estimated overall, by heritage group and by stroke risk factors. Multivariable logistic regression models estimated associations (odds ratio [OR], 95% CI) between heritage group and stroke risk factors with stroke symptoms, accounting for the complex study design and adjusting for age, sex, and sociodemographic factors. Results: Overall, 15% (n=1,448) reported experiencing > 1 stroke symptom in the past year. The most common stroke symptoms reported were sudden numbness (8%) followed by sudden weakness (6%). The prevalence of > 1 stroke symptom among those aged <50 years was 13% and 21% among those > 50. The prevalence was also highest among those of mixed heritage (20%), followed by Puerto Rican heritage (19%), and was lowest among those of Dominican heritage (10%). In age and sex-adjusted models, reporting > 1 stroke symptom was significantly lower among those of Dominican heritage (OR=0.51, 95%CI: 0.40-0.67) and Cuban heritage (OR=0.64, 95%CI: 0.53-0.78) compared to Mexican heritage, while those of mixed heritage exhibited a higher odds (OR=1.58, 95%CI: 1.16-2.15); estimates were unchanged after adjusting for clinical factors and medication. History of diabetes (OR=1.40, 95%CI: 1.17-1.60), CVD (OR=1.94, CI: 1.67-2.26), and current smoking (OR=1.50, 95%CI: 1.28-1.75) were significantly associated with greater odds of reporting > 1 stroke symptom, while odds were lower for males than females (OR=0.78, 95%CI: 0.68-0.89). Conclusions: This is the first study to assess the prevalence of stroke symptoms among U.S. Hispanic/Latino adults and demonstrates a high burden of stroke symptoms in this relatively young population. The prevalence varied across heritage groups and stroke risk factors indicating a need for stroke recognition education and targeted screening.

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