Some stroke disparities have ended between Mexican American, non-Hispanic white groups
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Certain ethnic stroke incidence disparities have ended in recent years, according to data from a population-based stroke surveillance study published in Neurology.
“Currently, data on contemporary trends in stroke rates are lacking, and there are very little data available for the last 5 years, which presents a gap in terms of quantifying the public health burden of stroke and planning near-term stroke prevention efforts,” Lynda D. Lisabeth, PhD, of the department of epidemiology at the University of Michigan School of Public Health, told Healio Neurology. “There are also very few studies that are able to provide meaningful trend data in minority populations, including Hispanic Americans, who bear a disproportionate stroke burden.”
In the current study, investigators aimed to examine trends in ischemic stroke rates based on ethnicity, sex and age via more recent data obtained between 2000 and 2017. They drew data from the Brain Attack Surveillance in Corpus Christi Project, conducted in a geographically isolated, bi-ethnic, urban community in Texas.
Researchers used active surveillance, which consisted of screening hospital admission logs, hospital wards and ICUs, as well as passive surveillance, which consisted of screening inpatient/ED discharge diagnosis codes, to identify 4,874 individuals with stroke aged 45 years or older. Stroke physicians validated these cases according to a consistent stroke definition over time. Further, they calculated ischemic stroke rates via Poisson regression with annual population counts from U.S. Census to estimate at-risk populations.
Among individuals aged 45 to 59 years, Lisabeth and colleagues noted a 104.3% relative increase in rates for non-Hispanic white individuals and a 21.9% relative decrease in Mexican American individuals, with rates significantly higher among non-Hispanic white individuals between 2016 and 2017. Individuals aged 60 to 74 years had declines in both ethnic groups, but these were more significant among Mexican American individuals (–40.1%) than among non-Hispanic white individuals (–18.2%). This resulted in similar rates for the two groups between 2016 and 2017. Those aged 75 years or older did not experience significant variance in trends according to ethnicity, with both groups having declines (non-Hispanic white individuals = –33.7%; Mexican American individuals = –26.9%). Men and women in the two older age groups exhibited decreases in rates; however, rates did not change among either sex in those aged 45 to 59 years.
“From a clinical perspective, the results point to renewed primary prevention efforts in all age groups are needed, particularly in midlife where increasing trends were seen in non-Hispanic whites, which was an unexpected finding," Lisabeth said.