STROKE INCIDENCE AND PROGNOSIS IN A MIXED ETHNIC REGION

死亡率数据表明，黑人中风的风险更高，但事实并非如此 很少有数据对比黑人的中风发病率、风险和预后， 西班牙裔和白人在同一人群中使用类似的方法。这 该提案将提供重要信息，帮助开发有针对性的中风 人口亚组中的预防战略可用于 实现2000年健康人口15.2的健康目标以减少中风 死亡。 这项修订后的前瞻性研究以医院和社区为基础，为期5年 旨在确定症状性中风的发生率，其效果 卒中危险因素与1-4年卒中预后(卒中复发、 死亡率和心肌梗死)的白人、非西班牙裔、黑人 非西班牙裔和西班牙裔男性和女性使用曼哈顿北部 人口。这项研究包括三个部分。第一，案例 监测将利用基于医院和社区的调查网络 用于枚举所有第一个笔划。中风将被归类为 脑内出血、蛛网膜下腔出血或脑梗塞 将根据诊断评估的结果对其进行细分。 按性别和种族/民族分列的中风亚型发病率将为 使用这项研究和调整后的1990年人口普查的数字进行估计 数据。第二，将确定脑梗塞的危险因素 通过病例对照研究，对病例(n=800)进行统一评估 随机选择首发脑梗塞患者和对照组(n=1600) 来自社区的中风风险因素评估。所有符合条件的 受试者将被录取、面试和考试。数据将是 通过对受试者的直接访谈或 代孕人口统计，中风风险因素，神经学检查， 空腹血脂谱和诊断性研究结果。最后， 前瞻性、年度面对面和半年度电话跟进 脑梗塞病例将测量中风复发、心肌梗死 脑梗塞和功能结局。探索性的单变量分析将 ，以确定与 兴趣和验证性多变量分析的结果将是 执行假设检验，种族/民族和性别为 控制其他风险因素的独立变量。

Mortality data suggest a higher risk of stroke among blacks, but there is little data contrasting stroke incidence, risk and prognosis in blacks, Hispanics and whites in the same population using similar methods. This proposal will provide vital information to help develop targeted stroke prevention strategies in population subgroups which can be used to achieve Health Objective 15.2 of Healthy People 2000 to reduce stroke deaths. This revised prospective, hospital and community based, 5-year study is designed to determine the incidence of symptomatic stroke, the effect of stroke risk factors and the 1-4 year stroke prognosis (stroke recurrence, mortality and myocardial infarction) in white non-Hispanic, black non-Hispanic and Hispanic men and women using the Northern Manhattan population. There are 3 components to this study. First, case surveillance will utilize hospital and community based survey networks for enumeration of all first strokes. Strokes will be classified as intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction which will be subdivided based on the results of diagnostic evaluation. Incidence of stroke subtypes by gender and race/ethnicity will be estimated using the numbers from this study and adjusted 1990 census data. Second, cerebral infarction risk factors will be identified through a case-control study where cases (n=800) are uniformly evaluated first cerebral infarct patients and controls (n=1600) randomly selected from the community for stroke risk factor assessments. All eligible subjects will be enrolled, interviewed and examined. Data will be collected systematically through direct interview of the subject or surrogate on demographics, stroke risk factors, neurological examination, fasting lipid profile and results of diagnostic studies. Finally, prospective, annual in-person and semi-annual telephone follow-up of the cerebral infarct cases will measure stroke recurrence, myocardial infarction and functional outcome. Exploratory univariate analyses will be done to identify variables that are marginally dependent on the outcome of interest and confirmatory multivariate analyses will be performed for hypothesis testing with race/ethnicity and gender as independent variables controlling for other risk factors.