Regional and racial differences among stroke victims in the United States

Roccella, Edward J.; Lenfant, Claude

doi:10.1002/clc.4960121306

Cited by 18 publications

(3 citation statements)

References 5 publications

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“…Disparities in stroke rates and stroke-related mortality are commonly reported in the so-called “stroke belt”, 1,2 with higher rates among African-American individuals than among whites. Beyond clinical stroke, African-Americans appear to be at increased risk for adverse subclinical brain changes and related sequelae, including cognitive impairment and dementia.…”

Section: Introductionmentioning

confidence: 99%

Brain Aging in African-Americans: The Atherosclerosis Risk in Communities (ARIC) Experience

Gottesman

Fornage²,

Knopman³

et al. 2015

CAR

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Reported rates of dementia differ by race, although most studies have not focused on carefully measured outcomes, confounding by education or other demographic factors, nor have they studied other outcomes to dementia. In this review we will discuss the experience in the Atherosclerosis Risk in Communities (ARIC) study evaluating racial disparities relating to stroke, subclinical brain infarction, leukoaraiosis, as well as cognitive change and dementia. ARIC is a biracial cohort of 15,792 participants from four U.S. communities, initially recruited in 1987–1989, and seen at a total of 5 in-person visits (most recently seen in 2011–2013 with annual follow-up phone calls. We will provide evidence from ARIC studies that disproportionate rates of vascular risk factors explain at least some of these observed disparities by race, but particular risk factors, including diabetes, may differentially affect the brain in African-American versus white participants. In addition, we will review some of the disparities by race in studies focusing on the genetics of stroke, small vessel disease, and dementia.

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Section: Introductionmentioning

confidence: 99%

Brain Aging in African-Americans: The Atherosclerosis Risk in Communities (ARIC) Experience

Gottesman

Fornage²,

Knopman³

et al. 2015

CAR

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“…This suggests that the halt in decline previously reported in years 1990–1994 has been reversed. Historically, the Southeast has been associated with higher mortality rates from congestive heart failure and heart disease 8 and a greater prevalence of hypertension among black females 9 and black and white men 10 . States in the Southeast have also had the highest overall stroke mortality rates since the 1970s for both men and women and for blacks and whites 11,12 .…”

Section: Discussionmentioning

confidence: 99%

The Impact of Changing ICD Code on Hypertension‐Related Mortality in the Southeastern United States from 1994–2005

Joyner-Grantham¹,

Simmons²,

Moore³

et al. 2010

J of Clinical Hypertension

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J Clin Hypertens (Greenwich). 2010;12:213–222. ©2010 Wiley Periodicals, Inc. Confusion surrounding cardiovascular disease trends arises when measurement and reporting of classification systems such as the International Classification of Diseases (ICD) code are revised. The current study examined the impact of ICD code revision on mortality trends for heart disease, cerebrovascular disease, and diabetes in 16 Southeast states using data published in the 1994–2005 Centers for Disease Control National Vital Statistics Reports. Data were averaged by year and analyzed separately before (1994–1998) and after (1999–2005) the ICD code change, pooled across codes using comparability ratios (1994–2005), and further compared at the year of ICD code change using standard error of 1998 data to determine whether corresponding 1999 rates fell within 95% confidence intervals. The change in classification did not alter Southeast US trends regarding a decrease in heart disease and cerebrovascular disease rates and an increase in diabetes mortality in years 1994–2005. On the other hand, the change in ICD code classification systems did impact mortality rates for heart disease, cerebrovascular disease, and diabetes, suggesting that change in code to ICD‐10 in 1999 underestimates heart disease and cerebrovascular disease and overestimates diabetes mortality rates in the Southeast United States. Health and disease burden profiles, which use mortality data to measure health status, need to carefully evaluate and report the influence of ICD code revisions as they draw conclusions. Primary care health providers should question the impact and comparability of ICD revision before accepting mortality trend conclusions.

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“…The geographic disparities in stroke and cerebrovascular disease have long been recognized with high-risk areas, such as the states in the Southeast with the greatest risk and identified as the Stroke Belt . These epidemiologic observations have facilitated the identification of risk factors associated with the excess disease burden as well as the benefits of interventions focused on disease control .…”

mentioning

confidence: 99%

Impact of Birth Place and Geographic Location on Risk Disparities in Cerebrovascular Disease

Lackland

2017

JAMA Neurol

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Regional and racial differences among stroke victims in the United States

Cited by 18 publications

References 5 publications

Brain Aging in African-Americans: The Atherosclerosis Risk in Communities (ARIC) Experience

Brain Aging in African-Americans: The Atherosclerosis Risk in Communities (ARIC) Experience

The Impact of Changing ICD Code on Hypertension‐Related Mortality in the Southeastern United States from 1994–2005

Impact of Birth Place and Geographic Location on Risk Disparities in Cerebrovascular Disease

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