Both Blacks and Hispanics of Caribbean descent living in Northern Manhattan have a significantly higher risk of stroke than their non-Hispanic, white neighbours, according to preliminary research to be presented today at the International Stroke Conference (ISC; 19–21 February, Los Angeles, USA). The study also found that the increased stroke risk persisted into old age (70 and older), while it appeared to be related to low socioeconomic status and other heart disease and stroke risk factors.
While previous research documented an increased stroke risk among blacks and Mexican Americans, studies in Northern Manhattan have been the first to document the heightened risk for Hispanics of Caribbean descent.
Researchers from the University of Miami and Columbia University analysed stroke risk in almost 3,300 people (average age 69; 37% men; 24% black; 21% white; 52% Hispanic) participating in the Northern Manhattan Study (NOMAS), an ongoing, community-based study that started in 1993 focused on stroke rates and risk factors.
Over an average follow-up time of more than 13 years, 460 participants had strokes, the majority of which were ischaemic strokes. Researchers also found:
- Overall, men had a 48% increased rate of stroke, even after adjusting for socioeconomic status and stroke risk factors;
- Compared with non-Hispanic whites, blacks had a 50% increased risk of stroke, even after adjusting for sociodemographic factors, including education and insurance;
- The disparity in stroke risk between blacks and whites was highest in women and persisted into old age (70 and older);
- Compared with non-Hispanic whites, Hispanics had a 50% increased risk of stroke, and the disparity was substantially reduced, except for among women 70 and older, after adjusting for socioeconomic status; and
- By age 85, the highest stroke incidence rate was in Hispanics.
“Previous research has suggested that racial and ethnic disparities in stroke risk are greater at younger ages and dissipate as people get older, so we were surprised to find that the differences remained strong in women over 70 years old,” said Hannah Gardener, lead author of the study, an epidemiologist and associate scientist in neurology at the University of Miami Miller School of Medicine in Miami, USA. “Disparities in stroke risk among elderly minorities are persistent. Identifying minority populations at a higher risk for stroke and targeting their modifiable risk factors are public health priorities.”
In addition to socioeconomic status, the study adjusted for the following stroke risk factors: smoking, physical activity, alcohol consumption, body mass index, high blood pressure, high cholesterol and diabetes.
“It is important for everyone to know their stroke risk factors, take their prescribed medications and make lifestyle changes that can reduce their risk,” Gardener said. “Risk factor management starting at or before middle age is key in reducing stroke risk, especially among blacks and Hispanics who are at increased risk.”
This study will be simultaneously published in the American Heart Association’s journal Stroke.