Lackland D T, Bachman D L, Carter T D, Barker D L, Timms S, Kohli H
Department of Biometry and Epidemiology, Medical University of South Carolina, Charleston, SC 29425-2203
Stroke. 1998 Oct;29(10):2061-8. doi: 10.1161/01.str.29.10.2061.
South Carolina and the southeastern United States have maintained the highest stroke mortality in the country. The Anderson and Pee Dee Stroke Study is an assessment of cerebrovascular disease incidence in 2 geographically defined communities in the stroke belt.
Strokes were identified in the Anderson and Pee Dee areas of South Carolina. All hospitalized and out-of-hospital deaths occurring during 1990 among the residents of these 2 areas were included. Strokes were classified by an independent panel of neurologists using a standard protocol that included specific criteria for stroke and subtypes.
The overall age-adjusted stroke incidence rates (per 100 000 population) were significantly higher in the Pee Dee population (293.1) compared with Anderson (211.2). The geographic differences were more dramatic in the younger age groups of 35 to 64 years. Likewise, incidence rates for blacks were nearly twice the rates for whites. The rates in the Pee Dee were higher than the rates from other studies in the United States and other parts of the world. Although the stroke subtypes did not vary between the 2 regions, race-sex differences were identified.
High stroke incidence and disease rates persist for all 4 race-sex groups in the Southeast and reflect similar risks as mortality rates. However, geographic variability in stroke rates suggests that the pattern of disease in the region is not so much a "belt" of increased stroke in contiguous areas but rather more a "necklace" of different levels of risk. These results should be useful in the identification of factors associated with this geographic enigma.
南卡罗来纳州及美国东南部地区的卒中死亡率一直位居全国之首。安德森和皮迪卒中研究旨在评估卒中带中两个地理区域内的脑血管疾病发病率。
在南卡罗来纳州的安德森和皮迪地区识别卒中病例。纳入了这两个地区居民在1990年期间发生的所有住院和院外死亡病例。由一组独立的神经科医生按照标准方案对卒中进行分类，该方案包括卒中及其亚型的特定标准。
皮迪地区人群的总体年龄调整卒中发病率（每10万人）显著高于安德森地区（293.1对211.2）。在35至64岁的较年轻年龄组中，地理差异更为显著。同样，黑人的发病率几乎是白人的两倍。皮迪地区的发病率高于美国其他研究以及世界其他地区的发病率。尽管两个地区的卒中亚型没有差异，但发现了种族 - 性别差异。
东南部所有四个种族 - 性别组的卒中发病率和疾病率持续居高不下，且反映出与死亡率相似的风险。然而，卒中率的地理变异性表明，该地区的疾病模式并非是相邻地区卒中增加的“带状”，而更像是不同风险水平的“项链”。这些结果对于识别与这一地理谜团相关的因素应具有帮助。
