Abstract 3476: Factors Affecting The Incidence of Spontaneous Intracerebral Hemorrhage in a Multiracial Community in Northern California.

Abstract

INTRODUCTION: Santa Clara County, California is a multi-racial community with a large Asian and Hispanic representation (30.6% Asian, 31.8% White and 31.9% Hispanics). The annual incidence of non-traumatic intracerebral hemorrhage (ICH) in our population is higher than the national average (29.2% vs. 13%) and the proportion of Asian patients with ICH is higher than expected (46.5% vs. 30.6% ). The reasons for the higher incidence of ICH in Asian populations are not known. We conducted a retrospective review of all cases of ICH in two Primary Stroke Centers in Santa Clara County, California to test the hypothesis that certain co-morbidities may explain the higher incidence of ICH in our community. METHODS: All cases of ICH admitted to two PSCs were abstracted from the Get With The Guidelines database. Data abstracted included racial and ethnic distribution (White, African American, Asian, Pacific Islander, Native American and Hispanic), age, sex, and selected co-morbidities (diabetes mellitus, hypertension and warfarin use. FINDINGS: There were a total of 260 patients. The total number of Pacific Islanders (4), Native Americans (1) and African Americans (13) was too small for further analysis and was not included. The age and sex distribution was similar between White, Asian and Hispanic patients but White women were significantly older (p = 0.018) than males. The rate of warfarin use was similar in all three groups. There was a higher incidence of hypertension and diabetes mellitus in Asian and Hispanics compared to White subjects ( Table ). Asian and Hispanic patients with hypertension and/or diabetes mellitus were at higher risk for ICH compared to White ( Table ). CONCLUSION: In our population, the incidence of ICH is disproportionately high in Asian subjects compared to Whites and Hispanics. This increase is only partially explained by higher incidence of hypertension and diabetes mellitus in Asians. Other factors, not included in the available databases, may include the geographic origin of Asian and Hispanic subjects (East vs. South Asian, North, Central or South American) and a generational effect on co-morbidities. Future epidemiological studies should include geographic and generational, as well as racial and ethnic data.