Neighborhood environment and risk of ischemic stroke - The Brain Attack Surveillance in Corpus Christi (BASIC) Project
Neighborhood environment and risk of ischemic stroke - The Brain Attack Surveillance in Corpus Christi (BASIC) Project
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DOI：
10.1093/aje/kwk005
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发表时间：
2007-02-01
影响因子：
5
通讯作者：
Morgenstern, L. B.
中科院分区：
文献类型：
--
作者：
Lisabeth, L. D.;Roux, A. V. Diez;Morgenstern, L. B.
作者探讨了社区水平的特征是否与缺血性卒中相关，以及这种相关性是否因种族、年龄和性别而异。他们使用来自Corpus Christi脑卒中监测项目（2000年1月至2003年6月）的数据，从医院和院外来源确定了缺血性卒中病例（n = 1，247）。人口普查区作为社区的代理，社区的社会经济地位得分是根据人口普查变量构建的（得分越高，代表越少的劣势）。在Poisson回归分析中，比较第90百分位数的邻居得分与第10百分位数，中风的相对危险度为0.49（95%置信区间（CI）：0.41，0.58）。调整年龄、性别和种族后，这种关联减弱（相对风险（RR）= 0.79，95%CI：0.63，1.00）。评分与卒中的相关性没有种族差异（相互作用p = 0.79）。显着效果modi.发现年龄（交互作用P < 0.001）和性别（交互作用P = 0.04）具有阳离子，增加的分数在男性和年轻人中对中风具有保护作用。调整教育后，相关性减弱（男性：RR = 0.77，95%CI：0.55，1.07;年龄< 65岁的人：RR = 0.65，95%CI：0.41，1.02）。社区特征可能会影响某些性别和年龄组的中风风险。应审查这些协会的机制。
The authors explored whether neighborhood-level characteristics are associated with ischemic stroke and whether the association differs by ethnicity, age, and gender. Using data from the Brain Attack Surveillance in Corpus Christi Project ( January 2000-June 2003), they identified cases of ischemic stroke (n = 1,247) from both hospital and out-of-hospital sources. Census tracts served as proxies for neighborhoods, and neighborhood socioeconomic status scores were constructed from census variables ( higher scores represented less disadvantage). In Poisson regression analyses comparing the 90th percentile of neighborhood score with the 10th, the relative risk of stroke was 0.49 (95% confidence interval (CI): 0.41, 0.58). After adjustment for age, gender, and ethnicity, this association was attenuated ( relative risk (RR) = 0.79, 95% CI: 0.63, 1.00). There was no ethnic difference in the association of score with stroke ( p for interaction = 0.79). Significant effect modi. cation was found for age ( p for interaction < 0.001) and gender ( p for interaction = 0.04), with increasing scores being protective against stroke in men and younger persons. Associations were attenuated after adjustment for education ( men: RR = 0.77, 95% CI: 0.55, 1.07; persons aged < 65 years: RR = 0.65, 95% CI: 0.41, 1.02). Neighborhood characteristics may influence stroke risk in certain gender and age groups. Mechanisms for these associations should be examined.