Journal article
Disparities in Stroke Incidence Contributing to Disparities in Stroke Mortality
Annals of neurology, v 69(4), pp 619-627
01 Apr 2011
PMID: 21416498
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: While black-white and regional disparities in U. S. stroke mortality rates are well documented, the contribution of disparities in stroke incidence is unknown. We provide national estimates of stroke incidence by race and region, contrasting these to publicly available stroke mortality data.
Methods: This analysis included 27,744 men and women without prevalent stroke (40.4% black), aged >= 45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) national cohort study, enrolled 2003-2007. Incident stroke was defined as first occurrence of stroke over 4.4 years of follow-up. Age-sex-adjusted stroke mortality rates were calculated using data from the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiological Research (WONDER) System.
Results: There were 460 incident strokes over 113,469 person-years of follow-up. Relative to the rest of the United States, incidence rate ratios (IRRs) of stroke in the southeastern stroke belt and stroke buckle were 1.06 (95% confidence interval [CI], 0.87-1.29) and 1.19 (95% CI, 0.96-1.47), respectively. The age-sex-adjusted black/white IRR(black) was 1.51 (95% CI, 1.26-1.81), but for ages 45-54 years the IRR(black) was 4.02 (95% CI, 1.23-13.11) while for ages 85+ it was 0.86 (95% CI, 0.33-2.20). Generally, the IRRs(black) were less than the mortality rate ratios (MRRs) across age groups; however, only in ages 55-64 years and 65-74 years did the 95% CIs of IRRs(black) not include the MRR(black). The MRRs for regions were within 95% CIs for IRRs.
Interpretation: National patterns of black-white and regional differences in stroke incidence are similar to those for stroke mortality; however, the magnitude of differences in incidence appear smaller. ANN NEUROL 2011; 69: 619-627
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Details
- Title
- Disparities in Stroke Incidence Contributing to Disparities in Stroke Mortality
- Creators
- Virginia J. Howard - University of Alabama at BirminghamDawn O. Kleindorfer - University of Cincinnati Medical CenterSuzanne E. Judd - University of Alabama at BirminghamLeslie A. McClure - University of Alabama at BirminghamMonika M. Safford - University of Alabama at BirminghamJ. David Rhodes - University of Alabama at BirminghamMary Cushman - University of VermontClaudia S. Moy - National Institute of Neurological Disorders and StrokeElsayed Z. Soliman - Wake Forest UniversityBrett M. Kissela - University of Cincinnati Medical CenterGeorge Howard - University of Alabama at Birmingham
- Publication Details
- Annals of neurology, v 69(4), pp 619-627
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- NINDS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) Allergan; AbbVie NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Boehringer Ingelheim U01 NS041588; NINDS R-01 NS039987; NCRR 1UL1 RR026314 / National Institutes of Health (National Institute of Neurological Disorders and Stroke); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) U01NS041588 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000290155800007
- Scopus ID
- 2-s2.0-79955425981
- Other Identifier
- 991019231650004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Neurosciences