Excess Stroke in Mexican Americans Compared with Non-Hispanic Whites: The Brain Attack Surveillance in Corpus Christi Project

Abstract

Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects' ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in Mexican Americans and 136/10,000 in non-Hispanic Whites. Mexican Americans had a higher cumulative incidence for ischemic stroke (ages 45-59 years: risk ratio = 2.04, 95% confidence interval: 1.55, 2.69; ages 60-74 years: risk ratio = 1.58, 95% confidence interval: 1.31, 1.91; ages >or=75 years: risk ratio = 1.12, 95% confidence interval: 0.94, 1.32). Intracerebral hemorrhage was more common in Mexican Americans (age-adjusted risk ratio = 1.63, 95% confidence interval: 1.24, 2.16). The subarachnoid hemorrhage age-adjusted risk ratio was 1.57 (95% confidence interval: 0.86, 2.89). Mexican Americans experience a substantially greater ischemic stroke and intracerebral hemorrhage incidence compared with non-Hispanic Whites. As the Mexican-American population grows and ages, measures to target this population for stroke prevention are critical.

Trends in Acute Ischemic Stroke Hospitalizations in the United States

“…Our findings are consistent with prior studies demonstrating higher AIS hospitalizations in blacks and Hispanics compared to whites 6, 8, 9, 10, 29. AIS hospitalization rates were greatest in blacks throughout the decade, and in 2010 were more than double the hospitalization rates of both whites and Hispanics.…”

“…The disparity was less pronounced between Hispanics and whites. In the Northern Manhattan population, AIS hospitalization rates for mainly Caribbean Hispanics were 1.7 times higher8 than whites and in a mainly Mexican community in Texas, 1.2 times higher than whites 10. In Florida, on the other hand, AIS hospitalization rates among a heterogeneous Hispanic population of Cubans, Puerto Ricans, Mexicans, and South Americans were 30% lower than whites 9…”

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

“…Although this study's findings could not establish a causal relationship between breastfeeding and risk of stroke, health disparities surrounding stroke1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 and breastfeeding rates52, 53, 54 persist. Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4.…”

“…Stroke costs the nation $34 billion annually including the cost of healthcare services, medications, and lost productivity 1. Approximately 55 000 more US women than men suffer from a stroke annually 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Compared with elderly men, elderly female stroke survivors are also at increased risk for moderate to severe disability, poorer quality of life, and institutionalization 16, 17…”

“…Stroke is higher among Hispanics and non‐Hispanic blacks compared with non‐Hispanic whites 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18. Hispanic and non‐Hispanic black women are at higher risk of stroke, partially due to increased rates of hypertension, obesity, diabetes mellitus, and physical inactivity,1, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 which are a few stroke risk factors.…”