Persistent ischemic stroke disparities despite declining incidence in Mexican Americans
Lewis B Morgenstern1, Melinda A Smith, Brisa N Sánchez
1Stroke Program, Department of Neurology, Veterans Affairs Center for Clinical Management and Research, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, MI; Department of Emergency Medicine, University of Michigan Medical School, Veterans Affairs Center for Clinical Management and Research, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, MI; Department of Epidemiology, Veterans Affairs Center for Clinical Management and Research, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, MI.
Annals of Neurology
|July 23, 2013
Summary
Ischemic stroke incidence declined in older adults of both ethnic groups, but disparities persist in younger Mexican Americans. Targeted prevention efforts are needed for this demographic.
Area of Science:
- Epidemiology
- Public Health
- Neurology
Background:
- Stroke incidence varies significantly across ethnic groups.
- Understanding ethnic disparities in stroke is crucial for targeted public health interventions.
Purpose of the Study:
- To analyze trends in ischemic stroke incidence among Mexican Americans and non-Hispanic whites.
- To identify age- and ethnicity-specific changes in stroke rates over a decade.
Main Methods:
- Population-based stroke surveillance conducted in Corpus Christi, Texas, from 2000 to 2010.
- Ascertainment and neurologist validation of ischemic stroke cases in individuals aged 45 and older.
- Calculation of crude and adjusted incidence rates using Poisson regression models.
Main Results:
- Ischemic stroke incidence declined by 35.9% overall during the study period.
- The decline was observed in individuals aged 60 years and older in both ethnic groups.
- Stroke rate disparities between Mexican Americans and non-Hispanic whites persisted in those under 75 years.
Conclusions:
- While overall stroke incidence has decreased, particularly in older adults, significant ethnic disparities remain in younger populations.
- The findings underscore the need for enhanced stroke prevention strategies specifically for younger Mexican American communities.
- Continued monitoring of stroke trends and disparities is essential for effective public health policy.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Ischemic Heart Disease: Overview
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...