中风风险因素对中年墨西哥裔美国人和非西班牙裔白人种族中风差异的影响。

Impact of Stroke Risk Factors on Ethnic Stroke Disparities Among Midlife Mexican Americans and Non-Hispanic Whites.

作者信息

Patel Rajiv C, Sánchez Brisa N, Morgenstern Lewis B, Li Chengwei, Lisabeth Lynda D

机构信息

From the Virginia Commonwealth University School of Medicine, Fairfax (R.C.P.); and Department of Epidemiology (L.B.M., C.L., L.D.L.) and Department of Biostatistics (B.N.S.), University of Michigan School of Public Health, Ann Arbor.

出版信息

Stroke. 2017 Oct;48(10):2872-2874. doi: 10.1161/STROKEAHA.117.018861.

DOI:10.1161/STROKEAHA.117.018861

PMID:28935697

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5659739/

Abstract

BACKGROUND AND PURPOSE

We examined the contribution of stroke risk factors to midlife (age 45-59 years) Mexican American and non-Hispanic White ischemic stroke (IS) rate disparities from 2000 to 2010.

METHODS

Incident IS cases (n=707) and risk factors were identified from the Brain Attack Surveillance in Corpus Christi Project, Nueces County, TX (2000-2010). US Census data (2000-2010) were used to estimate the population at-risk for IS, and the Behavioral Risk Factor Surveillance System (2000-2010) was used to estimate risk factor prevalence in the stroke-free population. Poisson regression models combined IS counts (numerator) and population at-risk counts (denominator) classified by ethnicity and risk factor status to estimate unadjusted and risk factor-adjusted associations between ethnicity and IS rates. Separate models were run for each risk factor and extended to include an interaction term between ethnicity and risk factor.

RESULTS

The crude rate ratio (RR) for ethnicity (Mexican American versus non-Hispanic White) was 2.01 (95% confidence interval [CI], 1.71-2.36) and was attenuated in models that adjusted for diabetes mellitus (RR: 1.50; 95% CI, 1.26-1.78) and hypertension (RR: 1.84; 95% CI, 1.50-2.26). In addition, diabetes mellitus had a stronger association with IS rates among Mexican Americans (RR: 6.42; 95% CI, 5.31-7.76) compared with non-Hispanic Whites (RR: 4.07; 95% CI, 3.68-4.51).

CONCLUSIONS

The higher prevalence of diabetes mellitus and hypertension and stronger association of diabetes mellitus with IS among midlife Mexican Americans likely contribute to persistent midlife ethnic stroke disparities.

摘要

背景与目的

我们研究了2000年至2010年间中风危险因素对中年（45 - 59岁）墨西哥裔美国人和非西班牙裔白人缺血性中风（IS）发生率差异的影响。

方法

从德克萨斯州纽埃西斯县科珀斯克里斯蒂市的脑卒中新发病例监测项目（2000 - 2010年）中确定新发IS病例（n = 707）及其危险因素。利用美国人口普查数据（2000 - 2010年）估算IS的高危人群数量，并使用行为危险因素监测系统（2000 - 2010年）估算无中风人群中危险因素的患病率。泊松回归模型将按种族和危险因素状态分类的IS病例数（分子）和高危人群数（分母）相结合，以估算种族与IS发生率之间未调整及经危险因素调整后的关联。针对每个危险因素分别运行模型，并扩展模型以纳入种族与危险因素之间的交互项。

结果

种族（墨西哥裔美国人与非西班牙裔白人）的粗发病率比（RR）为2.01（95%置信区间[CI]，1.71 - 2.36），在调整了糖尿病（RR：1.50；95% CI，1.26 - 1.78）和高血压（RR：1.84；95% CI，1.50 - 2.26）的模型中该比值降低。此外，与非西班牙裔白人（RR：4.07；95% CI，3.68 - 4.51）相比，糖尿病与墨西哥裔美国人的IS发生率之间的关联更强（RR：6.42；95% CI，5.31 - 7.76）。