Minority groups experience disproportionate stroke burden

Stroke burden varied by racial/ethnic groups, with higher adjusted prevalence and incidence among Black participants compared with white participants, according to findings from a cross-sectional study of more than 230,000 patients.

Researchers presented results from the All of Us research program, a novel population study from the NIH, at the American Academy of Neurology annual meeting, which is being held virtually.

“Several minority groups defined by factors other than race or ethnicity also have higher burden of stroke, including people older than 75 years, persons with physical disability and those with low income or without access to health insurance,” Julián N. Acosta, MD, a postdoctoral research fellow in the laboratory of Guido J. Falcone, MD, ScD, MPH, in the department of neurology at the Yale School of Medicine, said during his presentation.

Acosta and colleagues conducted a cross-sectional study using data from the NIH’s All of Us Research Program, which plans to compile health data from 1 million Americans. In the present analysis, participants over 18 years old who agreed to provide biological samples and electronic health record data completed several baseline surveys on demographics and medical history.

The cohort Acosta and colleagues analyzed using unadjusted prevalence ratios and logistic regression modeling included 230,577 participants, including 43,370 Black participants, 42,396 Hispanic participants, 23,618 participants who are older, 22,893 who are disabled, 43,468 who are uninsured, 77,431 with a low income and 28,084 of a sexual or gender minority.

When looking at the effect modification by sex at birth, Acosta said there were “a few interesting points” to be made, including the fact that males accounted for a higher stroke rate across most of the race and ethnic groups, but this was not the case for Black participants.

“In this case, Black women have a higher stroke prevalence than Black men,” he said. “Another interesting point from this paper is that even though male participants had similar stroke prevalence or gross income, this was not the case for female participants. Female participants with low income have higher stroke prevalence than those with higher income.”

Among all participants, 2.5% had experienced strokes at the time of enrollment. Overall, Acosta and colleagues found that stroke prevalence was significantly higher among Black people, older individuals, those who are disabled and those with low income (all P < .05). In addition, in exploratory time-to-event analyses, the researchers found that stroke incidence was significantly higher among Black and Hispanic participants (P < .001).

“The All of Us Research Program provides an invaluable resource for scientists advancing research among minorities,” Acosta said.