Morgenstern Lewis B, Smith Melinda A, Lisabeth Lynda D, Risser Jan M H, Uchino Ken, Garcia Nelda, Longwell Paxton J, McFarling David A, Akuwumi Olubumi, Al-Wabil Areej, Al-Senani Fahmi, Brown Devin L, Moyé Lemuel A
Stroke Program, University of Michigan Medical School, Ann Arbor, MI 48109-0316, USA.
Am J Epidemiol. 2004 Aug 15;160(4):376-83. doi: 10.1093/aje/kwh225.
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.
墨西哥裔美国人是西班牙裔中最大的亚群体,也是美国最大的少数族裔人口。中风是导致残疾的主要原因和第三大死因。作者在一项基于人群的研究中比较了墨西哥裔美国人和非西班牙裔白人的中风发病率。在得克萨斯州努埃塞斯县,利用主动监测和被动监测相结合的方式确定中风病例。病例由对受试者种族不知情的董事会认证神经科医生根据原始文件进行验证。2000年1月至2002年12月,共发生2350例脑血管事件。在完成的中风病例中,53%为墨西哥裔美国人。墨西哥裔美国人的粗累积发病率为168/10000,非西班牙裔白人为136/10000。墨西哥裔美国人缺血性中风的累积发病率更高(45 - 59岁:风险比 = 2.04,95%置信区间:1.55,2.69;60 - 74岁:风险比 = 1.58,95%置信区间:1.31,1.91;75岁及以上:风险比 = 1.12,95%置信区间:0.94,1.32)。脑出血在墨西哥裔美国人中更为常见(年龄调整风险比 = 1.63,95%置信区间:1.24,2.16)。蛛网膜下腔出血的年龄调整风险比为1.57(95%置信区间:0.86,2.89)。与非西班牙裔白人相比,墨西哥裔美国人经历缺血性中风和脑出血的发病率要高得多。随着墨西哥裔美国人口的增长和老龄化,针对该人群进行中风预防的措施至关重要。