Sacco R L, Kargman D E, Zamanillo M C
Neurological Institute, Sergievsky Center, Columbia-Presbyterian Medical Center, New York, NY, USA.
Neurology. 1995 Apr;45(4):659-63. doi: 10.1212/wnl.45.4.659.
African-Americans have an unexplained increased incidence and mortality from stroke compared with whites, and little is known about stroke in Hispanics. To investigate cross-sectional differences in sociodemographic and stroke risk factors, we prospectively evaluated 430 patients hospitalized for acute ischemic stroke (black 35%. Hispanic 46%, white 19%) over the age of 39 from Northern Manhattan. Blacks and Hispanics were younger than whites (mean ages, blacks 70, Hispanics 67, whites 80; p < 0.001) and were more likely to have less than 12 years of education than whites. Hypertension was more prevalent in blacks and Hispanics with stroke than whites (blacks 76%, Hispanics 79%, whites 63%; p < 0.05) and was often untreated in blacks. Left ventricular hypertrophy by ECG was more frequent in blacks (blacks 20%, whites 9%; p = 0.02). History of cardiac disease (atrial fibrillation, myocardial infarction, angina, and congestive heart failure) was less prevalent in both blacks and Hispanics. Black women were significantly more obese than white women (mean Quetelet Index percent, blacks 3.9%, whites 3.6%; p < 0.05). Heavy alcohol use was more often reported by blacks and Hispanics; cigarette smoking was increased only in blacks. Moreover, blacks were less likely to have visited a physician 1 year after their stroke (blacks 85%, whites 98%; p < 0.05), and Hispanics less often lived alone compared with whites. These cross-sectional differences suggest that the burden of stroke risk factors is increased in both blacks and Hispanics with stroke. Further studies controlling for stroke risk factors are needed to establish whether race-ethnicity is an independent determinant of stroke risk.
与白人相比，非裔美国人中风的发病率和死亡率出现了不明原因的上升，而西班牙裔人群的中风情况鲜为人知。为了研究社会人口统计学和中风风险因素的横断面差异，我们对来自曼哈顿北部39岁以上因急性缺血性中风住院的430名患者进行了前瞻性评估（黑人占35%，西班牙裔占46%，白人占19%）。黑人和西班牙裔比白人年轻（平均年龄，黑人70岁，西班牙裔67岁，白人80岁；p<0.001），且受教育年限低于12年的可能性比白人更大。中风患者中，高血压在黑人和西班牙裔中比白人更普遍（黑人76%，西班牙裔79%，白人63%；p<0.05），并且黑人的高血压常常未得到治疗。心电图显示左心室肥厚在黑人中更常见（黑人20%，白人9%；p = 0.02）。心脏病史（心房颤动、心肌梗死、心绞痛和充血性心力衰竭）在黑人和西班牙裔中都不太常见。黑人女性比白人女性明显更肥胖（平均体重指数百分比，黑人3.9%，白人3.6%；p<0.05）。黑人和西班牙裔报告的重度饮酒情况更多；只有黑人的吸烟率有所上升。此外，黑人中风后1年看医生的可能性较小（黑人85%，白人98%；p<0.05），与白人相比，西班牙裔独居的情况较少。这些横断面差异表明，中风患者中的黑人和西班牙裔的中风风险因素负担有所增加。需要进一步研究控制中风风险因素，以确定种族是否是中风风险的独立决定因素。
