Stroke incidence and survival among middle-aged adults - 9-year follow-up of the Atherosclerosis Risk in Communities (ARIC) cohort
Stroke incidence and survival among middle-aged adults - 9-year follow-up of the Atherosclerosis Risk in Communities (ARIC) cohort
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DOI：
10.1161/01.str.30.4.736
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发表时间：
1999-04-01
期刊：
影响因子：
8.3
通讯作者：
Shahar, E
中科院分区：
文献类型：
--
作者：
Rosamond, WD;Folsom, AR;Shahar, E
背景和目的 - 尽管美国的中风死亡率有充分的记录，对发病率和病例死亡的评估较少。从1987年到1995年，遵循4个美国社区，平均为7。2年。通过年度电话联系和医院记录搜索确定事件中风，然后进行验证。267个事件确定或可能的中风，将83％（n = 221）归类为缺血性中风，10％（n = 27）为脑内脑内出血和7％（n = 19）是蛛网膜下腔出血。在黑人男性（4.44）中，年龄调整后的发病率（每1000人年）最高，其次是黑人妇女（3.10），白人男性（1.78）和白人妇女（1.24）。缺血性中风的黑人与白人年龄调整后的率比（RR）为2.41（95％CI，1.85至3.15），在调整基线高度，糖尿病，糖尿病，教育，教育，教育，糖尿病，教育，糖尿病，糖尿病，教育，糖尿病，教育，教育，糖尿病，教育，糖尿病，教育，糖尿病，教育，糖尿病，教育，糖尿病，教育，糖尿病，教育，糖尿病，教育，糖尿病，教育，糖尿病，1.01至1.89至1.89至1.89时，为95％，1.01至1.89）为1.38（95％，1.01至1.89）。水平，吸烟状况和普遍的冠心病。在黑人和男性中，调整后的案件死亡率较高的趋势，尽管在性别或种族之间的病例比较均没有统计学意义。结论 - 考虑到既定的基线风险之后：因素，黑人仍然拥有38％与白人相比，出现缺血性中风的风险更大。确定新个人和社区级别的风险因素，该因素占中风的发病率升高需要进一步调查并纳入干预计划。
Background and Purpose-Although stroke mortality rates in the United States are well documented, assessment of incidence rates and case fatality are less well studied.Methods-A cohort of 15 792 men and women aged 45 to 64 years from a population sample of households in 4 US communities was followed from 1987 to 1995, an average of 7.2 years. Incident strokes were identified through annual phone contacts and hospital record searching and were then validated.Results-Of the 267 incident definite or probable strokes, 83% (n=221) were categorized as ischemic strokes, 10% (n=27) were intracerebral hemorrhages, and 7% (n=19) were subarachnoid hemorrhages. The age-adjusted incidence rate (per 1000 person-years) of total strokes was highest among black men (4.44), followed by black women (3.10), white men (1.78), and white women(1.24). The black versus white age-adjusted rate ratio (RR) for ischemic stroke was 2.41 (95% CI, 1.85 to 3.15), which was attenuated to 1.38 (95% CI, 1.01 to 1.89) after adjustment for baseline hypertension, diabetes, education level, smoking status, and prevalent coronary heart disease. There was a tendency for the adjusted case fatality rates to be higher among blacks and men, although none of the case fatality comparisons across sex or race was statistically significant.Conclusions-After accounting for established baseline risk:factors, blacks still had a 38% greater risk of incident ischemic stroke compared with whites. Identification of new individual and community-level risk factors accounting for the elevated incidence of stroke requires further investigation and incorporation into intervention planning.