EPIDEMIOLOGY OF STROKE IN BIRACIAL POPULATIONS

虽然中风的负担不成比例地福尔斯在黑人身上， 我们关于中风危险因素的大部分信息来自于研究 仅在白色人群中。 该研究计划详细介绍了一套 旨在更好地了解联合国系统内 birthday人群中中风的决定因素。 该提案基于五个假设： 1. 中风死亡率的黑人白人差异是由于 高血压的发病率和严重程度更高; 2. 中风死亡率的黑人白人差异主要是由于 黑人中风发病率更高， 病死率高; 3. 中风的危险因素在黑色和白色中的作用相似 但是，由于风险因素的分布不同， 在比赛之间，与每场比赛相关的击球百分比 风险因素在黑人和白人之间存在差异; 4. 脑卒中亚型与脑梗死部位的差异 黑人和白人之间的动脉粥样硬化可以解释为 已知危险因素分布的差异。 5. 中风在年轻人是不能充分解释的， 确定的危险因素如高血压的分布， 糖尿病和心脏损害。 为了验证这些假设，提出了六个子项目。 第一，风险 中风死亡率的因素将在 多风险因素干预试验。 第二，风险因素 中风发病率将在国家卫生和 营养检查调查流行病学随访研究。 第三，中风病死率的种族差异将是 NINCDS中风数据库中的研究。 第四，病例对照 在巴尔的摩的出生人口中进行的中风研究将 主要针对高血压、脂蛋白 异常和葡萄糖代谢。 第五，同样的风险 因素将与位置和严重程度相关， 血管造影定义的脑血管疾病。 此外该 建立一个以人口为基础的病例确定系统， 年轻的中风是建议。 这些资源将用于探索 年轻人中风率高的原因 黑人，并进行病例对照研究， 确定的风险因素。 这些项目将有助于最佳行程的设计 为我国各阶层人口制定预防战略。

Although the burden of stroke falls disproportionately on blacks, most of our information on stroke risk factors comes from studies in white populations only. This research plan details a set of interrelated subprojects aimed at a better understanding of the determinants of stroke in biracial populations. The proposal is based on five hypotheses: 1. The black-white difference in stroke mortality is due to a greater prevalence and severity of hypertension; 2. The black-white difference in stroke mortality is due primarily to a higher incidence of stroke among blacks rather than to a higher case-fatality rate; 3. Risk factors for stroke operate similarly in black and white populations but, because the distribution of risk factors differs between the races, the percentage of strokes associated with each risk factor differs between blacks and whites; 4. The differences in stroke subtypes and localization of cerebral atherosclerosis between blacks and whites is explainable by differences in the distribution of known risk factors. 5. Stroke in the young is not adequately explained by the distribution of established risk factors such as hypertension, diabetes and cardiac impairment. To test these hypotheses six subprojects are proposed. First, risk factors for stroke mortality will be studied in the screenees of the Multiple Risk Factor Intervention Trial. Second, risk factors for stroke incidence will be studied in the National Health and Nutrition Examination Survey Epidemiologic Followup Study. Third, racial differences in stroke case-fatality rates will be studied in the NINCDS Stroke Data Bank. Fourth, a case-control study of stroke in the biracial population of Baltimore will be developed focusing primarily on hypertension, lipoprotein abnormalities and glucose metabolism. Fifth, these same risk factors will be correlated with location and severity of angiographically defined cerebrovascular disease. In addition, the development of a population-based case ascertainment system for young strokes is proposed. This resource would be used to explore the reasons for the disproportionate stroke rate among young blacks, and to conduct case-control studies of less well established risk factors. These projects will contribute to the design of optimal stroke prevention strategies for all segmets of our population.