Disparities in Stroke Incidence among White, Black and Hispanics in the Northern Manhattan Study (S13.004)

Abstract

Objective: To determine stroke incidence rates among whites, blacks, and Hispanics in the same urban community. Background Hispanic Americans are now the largest minority in the United States (16.3%), but stroke incidence data among Hispanics is limited. Design/Methods: The Northern Manhattan Study is a population-based prospective cohort study of incidence, risk factors, and vascular outcomes in a multiethnic population. Participants were stroke-free at enrolment; race-ethnicity was self-identified. Participants were followed annually for incident stroke. We calculated age-adjusted incidence rates and 95% confidence intervals (95%CI) of stroke per 100,000 person-years overall and for Hispanics, and non-Hispanic (NH) blacks and whites separately, assuming a Poisson distribution. Results: Mean age (n=3298) was 69.2 ± 10.3 years; 62.8% were women; 20.9% were non-Hispanic white; 24.4% were non-Hispanic black; and 52.3% were Hispanic. There were 316 strokes during median follow-up 11 years. The overall age-adjusted stroke incidence rate was 952/100,000 person-years (95%CI 855-1050). Age-adjusted, race-ethnicity and sex-specific incidence rates (95%CI) per 100,000 person-years were: non-Hispanic white women 463 (268-658), NH black women 1089 (804-1375), Hispanic women 898 (710-1086), NH white men 1066 (CI 669-1463), NH black men 1250 (806-1693), and Hispanic men 1335 (957-1713). The relative rates, compared with white women, were 1.58 (p=0.039) for Hispanic women and 1.85 (p= 0.007) for NH black women; and 1.19 (p=0.438) for Hispanic men and 1.22 (p=0.446) for NH black men, compared to white men. Among those age ≤ 75, the incidence rates were three times higher in Hispanic (RR 3.1, p=0.005) and NH black women (RR 3.7, p=0.002), compared to white women. Conclusions: Among participants in a prospective cohort study, stroke incidence among women was greater for non-Hispanic blacks and Hispanics than among non-Hispanic whites. Among men, these race-ethnic disparities were less pronounced. Preventive efforts focused on minorities are needed. Disclosure: Dr. Battistella has nothing to disclose. Dr. Moon has nothing to disclose. Dr. Mora-McLaughlin has nothing to disclose. Dr. Wright has nothing to disclose. Dr. Rundek has nothing to disclose. Dr. Paik has nothing to disclose. Dr. Sacco has nothing to disclose. Dr. Elkind has received personal compensation for activities with Jarvik Heart, Bristol-Myers Squibb/Sanofi Pharmaceuticals, GlaxoSmithKline, Organon. Dr. Elkind has received personal compensation in an editorial capacity for the journal Neurology. Dr. Elkind has received research support from diaDexus, Inc., Bristol-Myers Squibb Company, Sanofi-Aventis Pharmaceuticals Inc., and the National Institute of Health.