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A comparison of stroke risk factors in patients enrolled in stroke prevention trials
G F Lynch1, S Leurgans, R Raman
1Department of Neurological Science, Rush University, Rush Medical College, Chicago, IL, USA.
Insights
African Americans have higher rates of stroke due to more prevalent risk factors like hypertension and diabetes, differing from predominantly white stroke prevention study groups.
Area of Science:
- Neuroscience
- Epidemiology
- Cardiovascular Medicine
Background:
- Stroke incidence is disproportionately high among African Americans.
- Prevalent stroke risk factors are suspected contributors to this disparity.
- Understanding these risk factors is crucial for effective stroke prevention.
Purpose of the Study:
- To compare stroke risk factor profiles in African Americans with predominantly white populations.
- To identify differences in baseline characteristics that may influence stroke incidence and outcomes.
Main Methods:
- The African-American Antiplatelet Stroke Prevention Study (AAASPS) baseline data (1,087 patients) were compared with 23 other stroke prevention studies (pNAA) comprising 53,293 predominantly non-African American patients.
- Data collected between December 1995 and June 1999.
- Statistical analysis included percentages for qualitative and means/SDs for quantitative characteristics, with confidence intervals for selected variables.
Main Results:
- Hypertension was significantly more prevalent in AAASPS (84%) compared to pNAA trials (27%-67%).
- Diabetes mellitus was also more common in AAASPS (39.1%) versus pNAA trials (17.1%).
- Cardiac disease was less frequent in AAASPS patients than in pNAA trial participants.
Conclusions:
- Significant differences exist in the baseline risk factor profiles between African American stroke patients and predominantly white populations.
- These disparities in hypertension and diabetes prevalence may impact stroke subtype prediction and treatment response.
- Further research is needed to understand how these differences affect stroke outcomes and adverse events in African Americans.
Abstract:
The high prevalence of stroke risk factors may explain, in part, the high incidence of stroke in African Americans. To further investigate the role of stroke risk factors, we compared stroke risk factor profiles of patients in the African-American Antiplatelet Stroke Prevention Study (AAASPS) with those in other stroke prevention studies in which the enrollees were predominately white. The baseline characteristics of the AAASPS enrollees obtained from an interim AAASPS database of 1,087 patients from 65 centers in the U.S. between December 1995 and June 1999 was compared to the baseline characteristics of 53,293 predominantly non-African American patients enrolled in 23 other stroke prevention studies (pNAA). Percentages were reported for qualitative characteristics, and means and standard deviations (SDs) for quantitative characteristics. For selected qualitative characteristics, 95% confidence intervals were given for population percentages in each study. The comparison of baseline characteristics showed that hypertension was more prevalent in AAASPS (84% [95% CI 82.2, 86.61) compared to pNAA trial patients (range of 27% to 67%). Diabetes mellitus was more common in AAASPS (39.1%) compared to pNAA trial patients (17.1%). Cardiac disease, however, was less common in AAASPS than in pNAA trials. The frequency of baseline characteristics of AAASPS patients is different from those of pNAA studies. Risk factor profiles are important as they may help to predict stroke subtype and outcome. Furthermore, the differences in baseline characteristics may portend differences in response to treatment and incidence of adverse events.
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