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American Journal of Epidemiology Vol. 147, No. 3: 259-268
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Stroke Incidence among White, Black, and Hispanic Residents of an Urban Community
The Northern Manhattan Stroke Study
1Gertrude H. Sergievsky Center, School of Public Health, Columbia University New York, NY
2Department of Neurology, College of Physicians and Surgeons, Columbia University New York, NY
3Division of Epidemiology, School of Public Health, Columbia University New York, NY
4Division of Biostatistics, School of Public Health, Columbia University New York, NY
5Department of Medicine, Division of General Medicine, College of Physicians and Surgeons, Columbia University New York, NY
Stroke mortality is reported to be greater in blacks than in whites, but stroke incidence data for blacks and Hispanics are sparse. The aim of this study was to determine and compare stroke incidence rates among whites, blacks, and Hispanics living in the same urban community. A population-based incidence study was conducted to identify all cases of first stroke occurring in northern Manhattan, New York City, between July 1, 1993, and June 30, 1996. The population of this area was approximately 210, 000 at that time, based on 1990 US Census data. Surveillance for hospitalized and nonhospitalized stroke consisted of daily screening of all admissions, discharges, and computed tomography logs at Columbia-Presbyterian Medical Center, the only hospital in the region, and review of discharge lists from outside hospitals, telephone surveys of random households, and contacts with community physicians, Visiting Nurses' Services, and community agencies. Stroke incidence increased with age and was greater in men than in women. The average annual age-adjusted stroke incidence rate at age 
20 years, per 100, 000 population, was 223 for blacks, 196 for Hispanics, and 93 for whites. Blacks had a 2.4-fold and Hispanics a twofold increase in stroke incidence compared with whites. Cerebral infarct accounted for 77 percent of all strokes, intracerebral hemorrhage for 17 percent, and subarachnoid hemorrhage for 6 percent. These data from the Northern Manhattan Stroke Study suggest that part of the reported excess stroke mortality among blacks in the United States may be a reflection of racial/ethnic differences in stroke incidence. Am J Epidemiol 1998; 147: 259–68.
blacks; cerebrovascular disorders; ethnic groups; Hispanic Americans; racial stocks
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 L. L. Barnes, C. F. M. De Leon, R. S. Wilson, J. L. Bienias, D. A. Bennett, and D. A. Evans Racial Differences in Perceived Discrimination in a Community Population of Older Blacks and Whites J Aging Health, June 1, 2004; 16(3): 315 - 337. [Abstract] [PDF]
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D. O.C. Corbin, V. Poddar, A. Hennis, A. Gaskin, C. Rambarat, R. Wilks, C. D.A. Wolfe, and H. S. Fraser Incidence and Case Fatality Rates of First-Ever Stroke in a Black Caribbean Population: The Barbados Register of Strokes Stroke, June 1, 2004; 35(6): 1254 - 1258. [Abstract] [Full Text] [PDF]
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R. L. Sacco Risk factors for TIA and TIA as a risk factor for stroke Neurology, April 27, 2004; 62(8_suppl_6): S7 - S11. [Full Text]
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B. Kissela, A. Schneider, D. Kleindorfer, J. Khoury, R. Miller, K. Alwell, D. Woo, J. Szaflarski, J. Gebel, C. Moomaw, et al. Stroke in a Biracial Population: The Excess Burden of Stroke Among Blacks Stroke, February 1, 2004; 35(2): 426 - 431. [Abstract] [Full Text] [PDF]
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J. P. Broderick William M. Feinberg Lecture: Stroke Therapy in the Year 2025: Burden, Breakthroughs, and Barriers to Progress Stroke, January 1, 2004; 35(1): 205 - 211. [Abstract] [Full Text] [PDF]
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T. Kurth, C. S. Kase, K. Berger, J. M. Gaziano, N. R. Cook, and J. E. Buring Smoking and Risk of Hemorrhagic Stroke in Women Stroke, December 1, 2003; 34(12): 2792 - 2795. [Abstract] [Full Text] [PDF]
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J. B. Christian, K. L. Lapane, and R. S. Toppa Racial Disparities in Receipt of Secondary Stroke Prevention Agents Among US Nursing Home Residents Stroke, November 1, 2003; 34(11): 2693 - 2697. [Abstract] [Full Text] [PDF]
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E. D. Louis, G. Levy, H. Mejia-Santana, L. Cote, H. Andrews, J. Harris, C. Waters, B. Ford, S. Frucht, S. Fahn, et al. Risk of action tremor in relatives of tremor-dominant and postural instability gait disorder PD Neurology, October 14, 2003; 61(7): 931 - 936. [Abstract] [Full Text] [PDF]
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S. L. Seliger, D. L. Gillen, D. Tirschwell, H. Wasse, B. R. Kestenbaum, and C. O. Stehman-Breen Risk Factors for Incident Stroke among Patients with End-Stage Renal Disease J. Am. Soc. Nephrol., October 1, 2003; 14(10): 2623 - 2631. [Abstract] [Full Text] [PDF]
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C. J. Rodriguez, S. Homma, R. L. Sacco, M. R. Di Tullio, R. R. Sciacca, and J.P. Mohr Race-Ethnic Differences in Patent Foramen Ovale, Atrial Septal Aneurysm, and Right Atrial Anatomy Among Ischemic Stroke Patients Stroke, September 1, 2003; 34(9): 2097 - 2102. [Abstract] [Full Text] [PDF]
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H. J. Fullerton, Y. W. Wu, S. Zhao, and S. C. Johnston Risk of stroke in children: Ethnic and gender disparities Neurology, July 22, 2003; 61(2): 189 - 194. [Abstract] [Full Text] [PDF]
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K. Marder, G. Levy, E. D. Louis, H. Mejia-Santana, L. Cote, H. Andrews, J. Harris, C. Waters, B. Ford, S. Frucht, et al. Accuracy of family history data on Parkinson's disease Neurology, July 8, 2003; 61(1): 18 - 23. [Abstract] [Full Text] [PDF]
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S.-H. Suk, R. L. Sacco, B. Boden-Albala, J. F. Cheun, J. G. Pittman, M. S. Elkind, and M. C. Paik Abdominal Obesity and Risk of Ischemic Stroke: The Northern Manhattan Stroke Study Stroke, July 1, 2003; 34(7): 1586 - 1592. [Abstract] [Full Text] [PDF]
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 P. B. Gorelick, D. Richardson, M. Kelly, S. Ruland, E. Hung, Y. Harris, S. Kittner, and S. Leurgans Aspirin and Ticlopidine for Prevention of Recurrent Stroke in Black Patients: A Randomized Trial JAMA, June 11, 2003; 289(22): 2947 - 2957. [Abstract] [Full Text] [PDF]
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R. L. Sacco Preventing Stroke Among Blacks: The Challenges Continue JAMA, June 11, 2003; 289(22): 3005 - 3007. [Full Text] [PDF]
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V. Novak, A. Chowdhary, B. Farrar, H. Nagaraja, J. Braun, R. Kanard, P. Novak, and A. Slivka Altered cerebral vasoregulation in hypertension and stroke Neurology, May 27, 2003; 60(10): 1657 - 1663. [Abstract] [Full Text] [PDF]
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 C. C Bassile, C. Dean, B. Boden-Albala, and R. Sacco Obstacle training programme for individuals post stroke: feasibility study Clinical Rehabilitation, February 1, 2003; 17(2): 130 - 136. [Abstract] [PDF]
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V. Gupta, N. C. Nanda, D. Yesilbursa, W. Y. Huang, V. Gupta, Q. Li, and C. R. Gomez Racial Differences in Thoracic Aorta Atherosclerosis Among Ischemic Stroke Patients Stroke, February 1, 2003; 34(2): 408 - 412. [Abstract] [Full Text] [PDF]
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A. T. Schneider, A. M. Pancioli, J. C. Khoury, E. Rademacher, A. Tuchfarber, R. Miller, D. Woo, B. Kissela, and J. P. Broderick Trends in Community Knowledge of the Warning Signs and Risk Factors for Stroke JAMA, January 15, 2003; 289(3): 343 - 346. [Abstract] [Full Text] [PDF]
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P. Piriyawat, M. Smajsova, M. A. Smith, S. Pallegar, A. Al-Wabil, N. M. Garcia, J. M. Risser, L. A. Moye, and L. B. Morgenstern Comparison of Active and Passive Surveillance for Cerebrovascular Disease: The Brain Attack Surveillance in Corpus Christi (BASIC) Project Am. J. Epidemiol., December 1, 2002; 156(11): 1062 - 1069. [Abstract] [Full Text] [PDF]
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B. S. Jacobs, B. Boden-Albala, I-F. Lin, and R. L. Sacco Stroke in the Young in the Northern Manhattan Stroke Study Stroke, December 1, 2002; 33(12): 2789 - 2793. [Abstract] [Full Text] [PDF]
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E. Z. Oddone, R. D. Horner, D. C.C. Johnston, K. Stechuchak, L. McIntyre, A. Ward, L. G. Alley, J. Whittle, L. Kroupa, and J. Taylor Carotid Endarterectomy and Race: Do Clinical Indications and Patient Preferences Account for Differences? Stroke, December 1, 2002; 33(12): 2936 - 2943. [Abstract] [Full Text] [PDF]
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 M. D. Wong, M. F. Shapiro, W. J. Boscardin, and S. L. Ettner Contribution of Major Diseases to Disparities in Mortality N. Engl. J. Med., November 14, 2002; 347(20): 1585 - 1592. [Abstract] [Full Text] [PDF]
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S. S. Rathore, A. R. Hinn, L. S. Cooper, H. A. Tyroler, and W. D. Rosamond Characterization of Incident Stroke Signs and Symptoms: Findings From the Atherosclerosis Risk in Communities Study Stroke, November 1, 2002; 33(11): 2718 - 2721. [Abstract] [Full Text] [PDF]
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H.J. Fullerton, D.M. Chetkovich, Y.W. Wu, W.S. Smith, and S.C. Johnston Deaths from stroke in US children, 1979 to 1998 Neurology, July 9, 2002; 59(1): 34 - 39. [Abstract] [Full Text] [PDF]
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C. Ayala, J. B. Croft, K. J. Greenlund, N. L. Keenan, R. S. Donehoo, A. M. Malarcher, and G. A. Mensah Sex Differences in US Mortality Rates for Stroke and Stroke Subtypes by Race/Ethnicity and Age, 1995-1998 Stroke, May 1, 2002; 33(5): 1197 - 1201. [Abstract] [Full Text] [PDF]
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C D A Wolfe, A G Rudd, R Howard, C Coshall, J Stewart, E Lawrence, C Hajat, and T Hillen Incidence and case fatality rates of stroke subtypes in a multiethnic population: the South London Stroke Register J. Neurol. Neurosurg. Psychiatry, February 1, 2002; 72(2): 211 - 216. [Abstract] [Full Text] [PDF]
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A. Hartmann, T. Rundek, H. Mast, M. C. Paik, B. Boden-Albala, J. P. Mohr, and R. L. Sacco Mortality and causes of death after first ischemic stroke: The Northern Manhattan Stroke Study Neurology, December 11, 2001; 57(11): 2000 - 2005. [Abstract] [Full Text] [PDF]
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