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. 1999 Apr 10;318(7189):967-71.
doi: 10.1136/bmj.318.7189.967.

Ethnic differences in incidence of stroke: prospective study with stroke register

J A Stewart  1 , R Dundas, R S Howard, A G Rudd, C D Wolfe
Affiliations

Ethnic differences in incidence of stroke: prospective study with stroke register

J A Stewart et al. BMJ. .

Abstract

Objective: To identify ethnic differences in the incidence of first ever stroke.

Design: A prospective community stroke register (1995-6) with multiple notification sources. Pathological classification of stroke in all cases was based on brain imaging or necropsy data. Rates were standardised to European and world populations and adjusted for age, sex, and social class in multivariate analysis.

Setting: A multi-ethnic population of 234 533 in south London, of whom 21% are black.

Results: 612 strokes were registered. The crude annual incidence rate was 1.3 strokes per 1000 population per year (95% confidence interval 1.20 to 1.41) and 1.25 per 1000 population per year (1.15 to 1.35) age adjusted to the standard European population. Incidence rates adjusted for age and sex were significantly higher in black compared with white people (P<0.0001), with an incidence rate ratio of 2.21 (1.77 to 2.76). In multivariable analysis increasing age (P<0.0001), male sex (P<0.003), black ethnic group (P<0.0001), and lower social class (P<0.0001) in people aged 35-64 were independently associated with an increased incidence of stroke.

Conclusions: Incidence rates of stroke are higher in the black population; this is not explained by confounders such as social class, age, and sex. Ethnic differences in genetic, physiological, and behavioural risk factors for stroke require further elucidation to aid development of effective strategies for stroke prevention in multi-ethnic communities.

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References

    1. Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas A, Schroll M. Stroke incidence, case fatality and mortality in the WHO MONICA project. Stroke. 1995;26:361–367. - PubMed
    1. Broderick JP, Phillips SJ, Whisnant JP, O’Fallon WM, Bergstrahl EJ. Incidence rates of stroke in the eighties: the end of the decline in stroke? Stroke. 1989;20:577–582. - PubMed
    1. Bamford J, Sandercock P, Dennis M. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire community stroke project 1981-86. 1. Methodology, demography and incident cases of first ever stroke. J Neurol Neurosurg Psychiatry. 1988;51:1373–1380. - PMC - PubMed
    1. Sacco RL, Boden-Albala B, Gan R, Chen X, Kargman DE, Shea S. Stroke incidence among white, black, and Hispanic residents of an urban Community. The Northern Manhattan stroke study. Am J Epidemiol. 1998;147:259–268. - PubMed
    1. Balarajan R. Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. BMJ. 1991;302:560–564. - PMC - PubMed