Incidence and risk factors for stroke in american indians the strong heart study

Ying Zhang, James M. Galloway, Thomas K. Welty, David O. Wiebers, Jack P. Whisnant, Richard B. Devereux, Jorge Kizer, Barbara V. Howard, Linda D. Cowan, Jeunliang Yeh, W. James Howard, Wenyu Wang, Lyle Best, Elisa T. Lee

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Background - There are few published data on the incidence of fatal and nonfatal stroke in American Indians. The aims of this observational study were to determine the incidence of stroke and to elucidate stroke risk factors among American Indians. Methods and Results - This report is based on 4549 participants aged 45 to 74 years at enrollment in the Strong Heart Study, the largest longitudinal, population-based study of cardiovascular disease and its risk factors in a diverse group of American Indians. At baseline examination in 1989 to 1992, 42 participants (age- and sex-adjusted prevalence proportion 1132/100 000, adjusted to the age and sex distribution of the US adult population in 1990) had prevalent stroke. Through December 2004, 306 (6.8%) of 4507 participants without prior stroke suffered a first stroke at a mean age of 66.5 years. The age- and sex-adjusted incidence was 679/100 000 person-years. Nonhemorrhagic cerebral infarction occurred in 86% of participants with incident strokes; 14% had hemorrhagic stroke. The overall age-adjusted 30-day case-fatality rate from first stroke was 18%, with a 1-year case-fatality rate of 32%. Age, diastolic blood pressure, fasting glucose, hemoglobin A 1c smoking, albuminuria, hypertension, prehypertension, and diabetes mellitus were risk factors for incident stroke. Conclusions - Compared with US white and black populations, American Indians have a higher incidence of stroke. The case-fatality rate for first stroke is also higher in American Indians than in the US white or black population in the same age range. Our findings suggest that blood pressure and glucose control and smoking avoidance may be important avenues for stroke prevention in this population.

Original languageEnglish (US)
Pages (from-to)1577-1584
Number of pages8
JournalCirculation
Volume118
Issue number15
DOIs
StatePublished - Oct 7 2008
Externally publishedYes

Fingerprint

North American Indians
Stroke
Incidence
Population
Blood Pressure
Mortality
Smoking
Prehypertension
Hemoglobin A
Sex Distribution
Albuminuria
Age Distribution
Cerebral Infarction
Observational Studies
Longitudinal Studies
Blood Glucose
Fasting
Diabetes Mellitus
Cardiovascular Diseases

Keywords

  • Morbidity
  • Mortality
  • Risk factors
  • Stroke

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Zhang, Y., Galloway, J. M., Welty, T. K., Wiebers, D. O., Whisnant, J. P., Devereux, R. B., ... Lee, E. T. (2008). Incidence and risk factors for stroke in american indians the strong heart study. Circulation, 118(15), 1577-1584. https://doi.org/10.1161/CIRCULATIONAHA.108.772285

Incidence and risk factors for stroke in american indians the strong heart study. / Zhang, Ying; Galloway, James M.; Welty, Thomas K.; Wiebers, David O.; Whisnant, Jack P.; Devereux, Richard B.; Kizer, Jorge; Howard, Barbara V.; Cowan, Linda D.; Yeh, Jeunliang; Howard, W. James; Wang, Wenyu; Best, Lyle; Lee, Elisa T.

In: Circulation, Vol. 118, No. 15, 07.10.2008, p. 1577-1584.

Research output: Contribution to journalArticle

Zhang, Y, Galloway, JM, Welty, TK, Wiebers, DO, Whisnant, JP, Devereux, RB, Kizer, J, Howard, BV, Cowan, LD, Yeh, J, Howard, WJ, Wang, W, Best, L & Lee, ET 2008, 'Incidence and risk factors for stroke in american indians the strong heart study', Circulation, vol. 118, no. 15, pp. 1577-1584. https://doi.org/10.1161/CIRCULATIONAHA.108.772285
Zhang Y, Galloway JM, Welty TK, Wiebers DO, Whisnant JP, Devereux RB et al. Incidence and risk factors for stroke in american indians the strong heart study. Circulation. 2008 Oct 7;118(15):1577-1584. https://doi.org/10.1161/CIRCULATIONAHA.108.772285
Zhang, Ying ; Galloway, James M. ; Welty, Thomas K. ; Wiebers, David O. ; Whisnant, Jack P. ; Devereux, Richard B. ; Kizer, Jorge ; Howard, Barbara V. ; Cowan, Linda D. ; Yeh, Jeunliang ; Howard, W. James ; Wang, Wenyu ; Best, Lyle ; Lee, Elisa T. / Incidence and risk factors for stroke in american indians the strong heart study. In: Circulation. 2008 ; Vol. 118, No. 15. pp. 1577-1584.
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AU - Galloway, James M.

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AU - Whisnant, Jack P.

AU - Devereux, Richard B.

AU - Kizer, Jorge

AU - Howard, Barbara V.

AU - Cowan, Linda D.

AU - Yeh, Jeunliang

AU - Howard, W. James

AU - Wang, Wenyu

AU - Best, Lyle

AU - Lee, Elisa T.

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N2 - Background - There are few published data on the incidence of fatal and nonfatal stroke in American Indians. The aims of this observational study were to determine the incidence of stroke and to elucidate stroke risk factors among American Indians. Methods and Results - This report is based on 4549 participants aged 45 to 74 years at enrollment in the Strong Heart Study, the largest longitudinal, population-based study of cardiovascular disease and its risk factors in a diverse group of American Indians. At baseline examination in 1989 to 1992, 42 participants (age- and sex-adjusted prevalence proportion 1132/100 000, adjusted to the age and sex distribution of the US adult population in 1990) had prevalent stroke. Through December 2004, 306 (6.8%) of 4507 participants without prior stroke suffered a first stroke at a mean age of 66.5 years. The age- and sex-adjusted incidence was 679/100 000 person-years. Nonhemorrhagic cerebral infarction occurred in 86% of participants with incident strokes; 14% had hemorrhagic stroke. The overall age-adjusted 30-day case-fatality rate from first stroke was 18%, with a 1-year case-fatality rate of 32%. Age, diastolic blood pressure, fasting glucose, hemoglobin A 1c smoking, albuminuria, hypertension, prehypertension, and diabetes mellitus were risk factors for incident stroke. Conclusions - Compared with US white and black populations, American Indians have a higher incidence of stroke. The case-fatality rate for first stroke is also higher in American Indians than in the US white or black population in the same age range. Our findings suggest that blood pressure and glucose control and smoking avoidance may be important avenues for stroke prevention in this population.

AB - Background - There are few published data on the incidence of fatal and nonfatal stroke in American Indians. The aims of this observational study were to determine the incidence of stroke and to elucidate stroke risk factors among American Indians. Methods and Results - This report is based on 4549 participants aged 45 to 74 years at enrollment in the Strong Heart Study, the largest longitudinal, population-based study of cardiovascular disease and its risk factors in a diverse group of American Indians. At baseline examination in 1989 to 1992, 42 participants (age- and sex-adjusted prevalence proportion 1132/100 000, adjusted to the age and sex distribution of the US adult population in 1990) had prevalent stroke. Through December 2004, 306 (6.8%) of 4507 participants without prior stroke suffered a first stroke at a mean age of 66.5 years. The age- and sex-adjusted incidence was 679/100 000 person-years. Nonhemorrhagic cerebral infarction occurred in 86% of participants with incident strokes; 14% had hemorrhagic stroke. The overall age-adjusted 30-day case-fatality rate from first stroke was 18%, with a 1-year case-fatality rate of 32%. Age, diastolic blood pressure, fasting glucose, hemoglobin A 1c smoking, albuminuria, hypertension, prehypertension, and diabetes mellitus were risk factors for incident stroke. Conclusions - Compared with US white and black populations, American Indians have a higher incidence of stroke. The case-fatality rate for first stroke is also higher in American Indians than in the US white or black population in the same age range. Our findings suggest that blood pressure and glucose control and smoking avoidance may be important avenues for stroke prevention in this population.

KW - Morbidity

KW - Mortality

KW - Risk factors

KW - Stroke

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