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Stroke in a biracial population: The excess burden of stroke among blacks
Excess mortality resulting from stroke is an important reason why blacks have higher age-adjusted mortality rates than whites. This observation has 2 possible explanations: Strokes occur more commonly among blacks or blacks have higher mortality rates after stroke. Our population-based epidemiologic...
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| Published in: | Stroke (1970) 2004-02, Vol.35 (2), p.426-431 |
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| container_end_page | 431 |
| container_issue | 2 |
| container_start_page | 426 |
| container_title | Stroke (1970) |
| container_volume | 35 |
| creator | KISSELA, Brett SCHNEIDER, Alexander PANCIOLI, Arthur JAUCH, Edward SHUKLA, Rakesh BRODERICK, Joseph KLEINDORFER, Dawn KHOURY, Jane MILLER, Rosemary ALWELL, Kathleen WOO, Daniel SZAFLARSKI, Jerzy GEBEL, James MOOMAW, Charles |
| description | Excess mortality resulting from stroke is an important reason why blacks have higher age-adjusted mortality rates than whites. This observation has 2 possible explanations: Strokes occur more commonly among blacks or blacks have higher mortality rates after stroke. Our population-based epidemiological study is set in the Greater Cincinnati/Northern Kentucky region of 1.31 million people, which is representative of the US white and black populations with regard to many demographic and socioeconomic characteristics.
Hospitalized cases were ascertained by International Classification of Diseases (ninth revision) discharge codes, prospective screening of emergency department admission logs, and review of coroner's cases. A sampling scheme was used to ascertain cases in the out-of-hospital setting. All potential cases underwent detailed chart abstraction by study nurses, followed by physician review. Race-specific incidence and case fatality rates were calculated.
We identified 3136 strokes during the study period (January 1, 1993, to June 30, 1994). Stroke incidence rates were higher for blacks at every age, with the greatest risk (2- to 5-fold) seen in young and middle-aged blacks ( |
| doi_str_mv | 10.1161/01.STR.0000110982.74967.39 |
| format | article |
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Hospitalized cases were ascertained by International Classification of Diseases (ninth revision) discharge codes, prospective screening of emergency department admission logs, and review of coroner's cases. A sampling scheme was used to ascertain cases in the out-of-hospital setting. All potential cases underwent detailed chart abstraction by study nurses, followed by physician review. Race-specific incidence and case fatality rates were calculated.
We identified 3136 strokes during the study period (January 1, 1993, to June 30, 1994). Stroke incidence rates were higher for blacks at every age, with the greatest risk (2- to 5-fold) seen in young and middle-aged blacks (<65 years of age). Case fatality rates did not differ significantly in blacks compared with whites. Applying the resulting age- and race-specific rates to the US population in 2002, we estimate that 705,000 to 740,000 strokes have occurred in the United States, with a minimum of 616,000 cerebral infarctions, 67,000 intracerebral hemorrhages, and 22,000 subarachnoid hemorrhages.
Excess stroke-related mortality in blacks is due to higher stroke incidence rates, particularly in the young and middle-aged. This excess burden of stroke incidence among blacks represents one of the most serious public health problems facing the United States.</description><identifier>ISSN: 0039-2499</identifier><identifier>ISSN: 1524-4628</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000110982.74967.39</identifier><identifier>PMID: 14757893</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Black or African American ; Black People - statistics & numerical data ; Female ; Humans ; Incidence ; Inpatients - statistics & numerical data ; Kentucky - epidemiology ; Male ; Medical sciences ; Middle Aged ; Mortality - trends ; Neurology ; Odds Ratio ; Ohio - epidemiology ; Outpatients - statistics & numerical data ; Risk Factors ; Sex Distribution ; Stroke - epidemiology ; Stroke - mortality ; United States - epidemiology ; Vascular diseases and vascular malformations of the nervous system ; White People - statistics & numerical data</subject><ispartof>Stroke (1970), 2004-02, Vol.35 (2), p.426-431</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c325t-624e288e71d3f52cb27c74ec1af1b31759af4e2896b1bccf8331cf835aba2aec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15432336$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14757893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KISSELA, Brett</creatorcontrib><creatorcontrib>SCHNEIDER, Alexander</creatorcontrib><creatorcontrib>PANCIOLI, Arthur</creatorcontrib><creatorcontrib>JAUCH, Edward</creatorcontrib><creatorcontrib>SHUKLA, Rakesh</creatorcontrib><creatorcontrib>BRODERICK, Joseph</creatorcontrib><creatorcontrib>KLEINDORFER, Dawn</creatorcontrib><creatorcontrib>KHOURY, Jane</creatorcontrib><creatorcontrib>MILLER, Rosemary</creatorcontrib><creatorcontrib>ALWELL, Kathleen</creatorcontrib><creatorcontrib>WOO, Daniel</creatorcontrib><creatorcontrib>SZAFLARSKI, Jerzy</creatorcontrib><creatorcontrib>GEBEL, James</creatorcontrib><creatorcontrib>MOOMAW, Charles</creatorcontrib><title>Stroke in a biracial population: The excess burden of stroke among blacks</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>Excess mortality resulting from stroke is an important reason why blacks have higher age-adjusted mortality rates than whites. This observation has 2 possible explanations: Strokes occur more commonly among blacks or blacks have higher mortality rates after stroke. Our population-based epidemiological study is set in the Greater Cincinnati/Northern Kentucky region of 1.31 million people, which is representative of the US white and black populations with regard to many demographic and socioeconomic characteristics.
Hospitalized cases were ascertained by International Classification of Diseases (ninth revision) discharge codes, prospective screening of emergency department admission logs, and review of coroner's cases. A sampling scheme was used to ascertain cases in the out-of-hospital setting. All potential cases underwent detailed chart abstraction by study nurses, followed by physician review. Race-specific incidence and case fatality rates were calculated.
We identified 3136 strokes during the study period (January 1, 1993, to June 30, 1994). Stroke incidence rates were higher for blacks at every age, with the greatest risk (2- to 5-fold) seen in young and middle-aged blacks (<65 years of age). Case fatality rates did not differ significantly in blacks compared with whites. Applying the resulting age- and race-specific rates to the US population in 2002, we estimate that 705,000 to 740,000 strokes have occurred in the United States, with a minimum of 616,000 cerebral infarctions, 67,000 intracerebral hemorrhages, and 22,000 subarachnoid hemorrhages.
Excess stroke-related mortality in blacks is due to higher stroke incidence rates, particularly in the young and middle-aged. This excess burden of stroke incidence among blacks represents one of the most serious public health problems facing the United States.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Black or African American</subject><subject>Black People - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Inpatients - statistics & numerical data</subject><subject>Kentucky - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality - trends</subject><subject>Neurology</subject><subject>Odds Ratio</subject><subject>Ohio - epidemiology</subject><subject>Outpatients - statistics & numerical data</subject><subject>Risk Factors</subject><subject>Sex Distribution</subject><subject>Stroke - epidemiology</subject><subject>Stroke - mortality</subject><subject>United States - epidemiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><subject>White People - statistics & numerical data</subject><issn>0039-2499</issn><issn>1524-4628</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><recordid>eNpFkE1Lw0AQhhdRbK3-BVkEvSXu7EeS7U2KH4WCYOt5md1uNDZN6m4D-u9NbaFzeOfyvDPwEHIDLAXI4J5BOl-8pawfAKYLnuZSZ3kq9AkZguIykRkvTsmQMaETLrUekIsYv3qei0KdkwHIXOWFFkMynW9Du_K0aihSWwV0FdZ00266GrdV24zp4tNT_-N8jNR2Yekb2pY07lu4bpsPamt0q3hJzkqso7867BF5f3pcTF6S2evzdPIwS5zgaptkXHpeFD6HpSgVd5bnLpfeAZZgBeRKY7kjdGbBOlcWQsAuFVrk6J0Ykbv93U1ovzsft2ZdRefrGhvfdtEUDCQHxXpwvAddaGMMvjSbUK0x_BpgZifSMDC9SHMUaf5FGqH78vXhS2fXfnmsHsz1wO0BwOiwLgM2ropHTknBhcjEH_q_fD4</recordid><startdate>20040201</startdate><enddate>20040201</enddate><creator>KISSELA, Brett</creator><creator>SCHNEIDER, Alexander</creator><creator>PANCIOLI, Arthur</creator><creator>JAUCH, Edward</creator><creator>SHUKLA, Rakesh</creator><creator>BRODERICK, Joseph</creator><creator>KLEINDORFER, Dawn</creator><creator>KHOURY, Jane</creator><creator>MILLER, Rosemary</creator><creator>ALWELL, Kathleen</creator><creator>WOO, Daniel</creator><creator>SZAFLARSKI, Jerzy</creator><creator>GEBEL, James</creator><creator>MOOMAW, Charles</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040201</creationdate><title>Stroke in a biracial population: The excess burden of stroke among blacks</title><author>KISSELA, Brett ; SCHNEIDER, Alexander ; PANCIOLI, Arthur ; JAUCH, Edward ; SHUKLA, Rakesh ; BRODERICK, Joseph ; KLEINDORFER, Dawn ; KHOURY, Jane ; MILLER, Rosemary ; ALWELL, Kathleen ; WOO, Daniel ; SZAFLARSKI, Jerzy ; GEBEL, James ; MOOMAW, Charles</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c325t-624e288e71d3f52cb27c74ec1af1b31759af4e2896b1bccf8331cf835aba2aec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Black or African American</topic><topic>Black People - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Inpatients - statistics & numerical data</topic><topic>Kentucky - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality - trends</topic><topic>Neurology</topic><topic>Odds Ratio</topic><topic>Ohio - epidemiology</topic><topic>Outpatients - statistics & numerical data</topic><topic>Risk Factors</topic><topic>Sex Distribution</topic><topic>Stroke - epidemiology</topic><topic>Stroke - mortality</topic><topic>United States - epidemiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><topic>White People - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KISSELA, Brett</creatorcontrib><creatorcontrib>SCHNEIDER, Alexander</creatorcontrib><creatorcontrib>PANCIOLI, Arthur</creatorcontrib><creatorcontrib>JAUCH, Edward</creatorcontrib><creatorcontrib>SHUKLA, Rakesh</creatorcontrib><creatorcontrib>BRODERICK, Joseph</creatorcontrib><creatorcontrib>KLEINDORFER, Dawn</creatorcontrib><creatorcontrib>KHOURY, Jane</creatorcontrib><creatorcontrib>MILLER, Rosemary</creatorcontrib><creatorcontrib>ALWELL, Kathleen</creatorcontrib><creatorcontrib>WOO, Daniel</creatorcontrib><creatorcontrib>SZAFLARSKI, Jerzy</creatorcontrib><creatorcontrib>GEBEL, James</creatorcontrib><creatorcontrib>MOOMAW, Charles</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KISSELA, Brett</au><au>SCHNEIDER, Alexander</au><au>PANCIOLI, Arthur</au><au>JAUCH, Edward</au><au>SHUKLA, Rakesh</au><au>BRODERICK, Joseph</au><au>KLEINDORFER, Dawn</au><au>KHOURY, Jane</au><au>MILLER, Rosemary</au><au>ALWELL, Kathleen</au><au>WOO, Daniel</au><au>SZAFLARSKI, Jerzy</au><au>GEBEL, James</au><au>MOOMAW, Charles</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stroke in a biracial population: The excess burden of stroke among blacks</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2004-02-01</date><risdate>2004</risdate><volume>35</volume><issue>2</issue><spage>426</spage><epage>431</epage><pages>426-431</pages><issn>0039-2499</issn><issn>1524-4628</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>Excess mortality resulting from stroke is an important reason why blacks have higher age-adjusted mortality rates than whites. This observation has 2 possible explanations: Strokes occur more commonly among blacks or blacks have higher mortality rates after stroke. Our population-based epidemiological study is set in the Greater Cincinnati/Northern Kentucky region of 1.31 million people, which is representative of the US white and black populations with regard to many demographic and socioeconomic characteristics.
Hospitalized cases were ascertained by International Classification of Diseases (ninth revision) discharge codes, prospective screening of emergency department admission logs, and review of coroner's cases. A sampling scheme was used to ascertain cases in the out-of-hospital setting. All potential cases underwent detailed chart abstraction by study nurses, followed by physician review. Race-specific incidence and case fatality rates were calculated.
We identified 3136 strokes during the study period (January 1, 1993, to June 30, 1994). Stroke incidence rates were higher for blacks at every age, with the greatest risk (2- to 5-fold) seen in young and middle-aged blacks (<65 years of age). Case fatality rates did not differ significantly in blacks compared with whites. Applying the resulting age- and race-specific rates to the US population in 2002, we estimate that 705,000 to 740,000 strokes have occurred in the United States, with a minimum of 616,000 cerebral infarctions, 67,000 intracerebral hemorrhages, and 22,000 subarachnoid hemorrhages.
Excess stroke-related mortality in blacks is due to higher stroke incidence rates, particularly in the young and middle-aged. This excess burden of stroke incidence among blacks represents one of the most serious public health problems facing the United States.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>14757893</pmid><doi>10.1161/01.STR.0000110982.74967.39</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0039-2499 |
| ispartof | Stroke (1970), 2004-02, Vol.35 (2), p.426-431 |
| issn | 0039-2499 1524-4628 1524-4628 |
| language | eng |
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| subjects | Adult Age Distribution Aged Aged, 80 and over Biological and medical sciences Black or African American Black People - statistics & numerical data Female Humans Incidence Inpatients - statistics & numerical data Kentucky - epidemiology Male Medical sciences Middle Aged Mortality - trends Neurology Odds Ratio Ohio - epidemiology Outpatients - statistics & numerical data Risk Factors Sex Distribution Stroke - epidemiology Stroke - mortality United States - epidemiology Vascular diseases and vascular malformations of the nervous system White People - statistics & numerical data |
| title | Stroke in a biracial population: The excess burden of stroke among blacks |
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