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American Journal of Epidemiology 2004 160(4):376-383; doi:10.1093/aje/kwh225
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Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Excess Stroke in Mexican Americans Compared with Non-Hispanic Whites

The Brain Attack Surveillance in Corpus Christi Project

Lewis B. Morgenstern1,2 , Melinda A. Smith1, Lynda D. Lisabeth1, Jan M. H. Risser3, Ken Uchino4, Nelda Garcia1, Paxton J. Longwell5, David A. McFarling6, Olubumi Akuwumi7, Areej Al-Wabil4, Fahmi Al-Senani4, Devin L. Brown1 and Lemuel A. Moyé7

1 Stroke Program, University of Michigan Medical School, Ann Arbor, MI.
2 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.
3 Department of Epidemiology, University of Texas School of Public Health, Houston, TX.
4 Stroke Program, University of Texas Medical School, Houston, TX.
5 Corpus Christi Neurology, Corpus Christi, TX.
6 Neurology P.A., Corpus Christi, TX.
7 Department of Biometry, University of Texas School of Public Health, Houston, TX.

Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects’ ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in Mexican Americans and 136/10,000 in non-Hispanic Whites. Mexican Americans had a higher cumulative incidence for ischemic stroke (ages 45–59 years: risk ratio = 2.04, 95% confidence interval: 1.55, 2.69; ages 60–74 years: risk ratio = 1.58, 95% confidence interval: 1.31, 1.91; ages ≥75 years: risk ratio = 1.12, 95% confidence interval: 0.94, 1.32). Intracerebral hemorrhage was more common in Mexican Americans (age-adjusted risk ratio = 1.63, 95% confidence interval: 1.24, 2.16). The subarachnoid hemorrhage age-adjusted risk ratio was 1.57 (95% confidence interval: 0.86, 2.89). Mexican Americans experience a substantially greater ischemic stroke and intracerebral hemorrhage incidence compared with non-Hispanic Whites. As the Mexican-American population grows and ages, measures to target this population for stroke prevention are critical.

cerebral hemorrhage; cerebrovascular accident; ethnic groups; Hispanic Americans; ischemic attack, transient; Mexican Americans; population surveillance; subarachnoid hemorrhage

Abbreviations: Abbreviation: BASIC, Brain Attack Surveillance in Corpus Christi.


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