The ethnic differences of stroke in Yakutia

Abstract

BackgroundIn Yakutia, the morbidity and mortality from stroke increased in the past 2 decades. Stroke share in the total mortality structure increased significantly. According to the autopsies, haemorrhagic stroke (HS) was more common in indigenous patients.ObjectiveThe aim of the study was to examine ethnic features of stroke patients of indigenous and non-indigenous ethnicity admitted to Regional Vascular Center (RVC), Yakutsk.DesignThe study used data from a hospital stroke registry, which took into account the cases of acute stroke in 2011. Stroke type and aetiology were determined by clinical examination, computed tomography and magnetic resonance imaging studies, cerebral angiography and ultrasound of cerebral vessels.ResultsA total of 1,108 patients were hospitalized (51.4% male, n=569) in 2011. The mean age was 60.5±12.9 years, male: 59.1±12.8, female: 61.9±13.05. Five hundred and ninety-two ischemic strokes (IS; 53.4%), 236 HS (21.3%), 280 transient ischemic attacks (TIA; 25.3%) were diagnosed. Patients who had a stroke were divided into 3 groups according to their ethnicity: native (n=411; 49.6%), Russians (n=347; 41.9%) and other nationalities (n=70; 8.5%). When comparing the incidence of HS in different ethnic groups, it was found that indigenous patients had more cases of HS than Russians (38% vs. 20.2%, p<0.05; adjusted odds ratio=2.42; 95% confidence interval: 1.72–3.41). Mean age of IS and HS indigenous patients had no significant differences compared with the average age of Russian ethnicity patients (p=0.69; p=0.201, respectively).ConclusionsThe data from this study suggest that among the patients who suffered from stroke in the indigenous population, the share of a haemorrhagic form washigher than those of non-indigenous Caucasians. At the same time, the average age of patients, both having IS and HS had no significant differences by ethnicity. Further studies are needed to establish the causes of ethnic differences of stroke in Yakutia.

A narrative review of stroke incidence, risk factors and treatment in Indigenous Peoples of the world

“…In a study in Yakutia, Russia, a region which is home to a significant proportion of Indigenous Peoples (including Yakuts, Evenks, Evens, Dolgans, Yukagirs and Chukchi Peoples), there were no significant differences in the mean age of incident stroke [33] . Still, the proportion of haemorrhagic stroke was greater in the Indigenous patients (38%) than in the Caucasian Russian patients with incident stroke (20.2%, P < 0.05) [32] .…”

“…This disparity was seen to a lesser extent in reindeer-herding Sami men (standardised incidence ratio of 1.4), though with overlapping confidence intervals. Interestingly, reindeer-herding Sami women had a significantly lower incidence of myocardial infarction than non-Sami women [32] . In a study in Yakutia, Russia, a region which is home to a significant proportion of Indigenous Peoples (including Yakuts, Evenks, Evens, Dolgans, Yukagirs and Chukchi Peoples), there were no significant differences in the mean age of incident stroke [33] .…”

“…Within the constraints of a narrative review, stroke incidence rates appear variable between the Indigenous and non-Indigenous populations, depending on the country. From the available studies in our review, incidence rates are greater for Indigenous groups of Australia [11,[14][15][16] , New Zealand [17] , Sweden [32] , and Israel [20] . There are conflicting reports from the United States [23][24][25][26] and Canada [27,28,30] and incidence rates are either similar or lower in South America [31] , Russia [33] and Tibet [19] .…”

“…In Europe and Russia, disparities in the incidence of stroke between the Indigenous and non-Indigenous populations are less clear. In Scandinavia, the incidence of stroke has been reported to be greater in the Sami population compared with that in the non-Sami population of the same Nordic regions [31,32] , with notable differences also reported between reindeer-herder and non-herder Sami people [32] . Sjölander et al [32] reported a greater incidence of stroke in the Sami population of Sweden overall, when compared with the non-Sami population.…”

“…In Scandinavia, the incidence of stroke has been reported to be greater in the Sami population compared with that in the non-Sami population of the same Nordic regions [31,32] , with notable differences also reported between reindeer-herder and non-herder Sami people [32] . Sjölander et al [32] reported a greater incidence of stroke in the Sami population of Sweden overall, when compared with the non-Sami population. However, reindeer-herding Sami men had a significantly lower age-adjusted incidence of stroke, and reindeer-herding Sami women had a significantly greater incidence of stroke, when compared to the non-Sami population.…”