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Racial differences in cerebrovascular disease hospitalizations
A L Klatsky1, M A Armstrong, G D Friedman
1Department of Medicine, Kaiser Permanente Medical Care Program, Oakland, Calif. 94611-5693.
Stroke
|March 1, 1991
Summary
Blacks face higher hospitalization risks for certain cerebrovascular diseases like hemorrhagic stroke and cerebral thrombosis compared to whites. However, they have a lower risk for extracranial occlusive disease, indicating complex racial disparities in stroke incidence.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Cerebrovascular disease (stroke) is a leading cause of morbidity and mortality.
- Understanding racial disparities in stroke incidence and type is crucial for targeted prevention and treatment.
Purpose of the Study:
- To investigate the relationship between race and the incidence of hospitalization for different types of cerebrovascular disease.
- To identify specific cerebrovascular disease subtypes where racial differences in hospitalization risk are most pronounced.
Main Methods:
- Analysis of hospitalization data from 74,096 white and 33,041 black individuals in a prepaid health care program.
- Statistical adjustments for multiple confounding factors including age, sex, BMI, lifestyle factors, and blood pressure.
- Calculation of relative risks and confidence intervals to compare hospitalization rates between racial groups for various cerebrovascular disease types.
Main Results:
- Black individuals exhibited significantly higher hospitalization risks for hemorrhagic cerebrovascular disease (RR=2.4), cerebral thrombosis (RR=1.9), and nonspecific cerebrovascular disease (RR=1.6) compared to white individuals.
- Conversely, black individuals had a lower hospitalization risk for extracranial occlusive disease (RR=0.4).
- While blood pressure influenced all cerebrovascular disease types similarly across races, other atherosclerosis risk factors showed disparate relationships, and educational attainment did not explain the disparity in extracranial occlusive disease.
Conclusions:
- Significant, unexplained racial differences exist in the incidence and type of cerebrovascular disease hospitalization.
- These disparities highlight the need for further research into the pathogenesis of cerebrovascular disease and have important clinical implications for risk assessment and management in diverse populations.