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Etiology of Geographic and Racial Differences in Stroke

中风的地理和种族差异的病因学

基本信息

批准号：
7210732
负责人：
George Howard
金额：
$ 281.67万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-09-19 至 2008-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7210732
关键词：
Address Adverse effects Advisory Committees Affect African African American Age Age Distribution Agreement Albumins Albuminuria American American Heart Association Ancillary Study Anniversary Appendix Area Attention Attitude Authorization documentation Automation Award Back Bar Codes Biological Biological Assay Blood Blood Pressure Blood Tests Blood pressure determination Blood specimen Budgets C-reactive protein California Candidate Disease Gene Categories Cells Censuses Centrifugation Cessation of life Characteristics Chest Chicago Cholesterol Chronic Class Client Clinic Clinical Coagulation Process Code Cohort Studies Collaborations Collection Communication Communities Community Developments Compatible Computer Assisted Computer Systems Computer Systems Development Condition Consent Forms Consultations Count Country Creatinine Custom Data Data Collection Databases Demographic Factors Development Diabetes Mellitus Dictionary Differential Mortality Directories Documentation Dropout Dropout Characteristic Drops Edetic Acid Education Educational Background Educational Status Electrocardiogram Elements Eligibility Determination Employee Employee Strikes End Point Enrollment Epidemiologic Studies Ethnic group Etiology Evaluation Event Excess Mortality Faculty Fasting Feedback Fees Female Fibrin fragment D Fluorides Focus Groups Frequencies Funding Future General Population Genes Genetic Genetic Materials Geographic Distribution Geographic Information Systems Geographic Locations Glucose Goals Gold Grant Graph Health Health Professional Heart Diseases Home environment Home visitation Hour House Call Human Human Resources Hylobates Genus Hypertension Illinois Incentives Incidence Individual Ineligibility Infection Inflammation Information Systems Information Technology Informed Consent Institutes Internet Interview Interviewer Invasive Journals Kidney Failure Label Laboratories Lasers Lead Learning Legitimacy Letters Life Life Style Light Link Lipids Literature Location Mails Malignant neoplasm of lung Manuals Marital Status Materials Testing Measurement Measures Mechlorethamine/Procarbazine/Vincristine Media Campaign Mediation Medical Medical History Medical Records Methods Microalbuminuria Minnesota Minor Mississippi Modification Monitor Morphologic artifacts Names Neurologic Newspapers None or Not Applicable Numbers Operative Surgical Procedures Oregon Outcome Pamphlets Parents Participant Paste substance Patient Self-Report Persons Pharmaceutical Preparations Phase Physicians Pilot Projects Placebos Placement Policies Population Predisposition Preparation Prevalence Principal Investigator Printing Procedures Process Productivity Proteins Protocols documentation Public Health Published Comment Published Directory Publishing Questionnaires Race Range Rate Recommendation Recording of previous events Recruitment Activity Regrets Reporting Research Research Activity Research Ethics Committees Research Infrastructure Research Personnel Resolution Resources Respondent Rest Retrieval Review Committee Rewards Risk Risk Factors Role Running Rural Rural Community Sample Size Sampling Sampling Studies Scanning Schedule Self-Administered Series Serum Services Shipping Ships Site Socioeconomic Status Sodium Fluoride Source Specific qualifier value Specimen Speed Staging Standardization Standards of Weights and Measures Stress Stroke Study Subject Surveys System Techniques Telephone Telephone Interviews Telephone Number Testing Texas Text Thinking Time Today Tourniquets Training Training Programs Translating Triglycerides Tube United States National Institutes of Health Universities Update Urine Validation Value Meaning Venipunctures Venous blood sampling Vermont Vial device Visit Waco Washington Week Women&apos s Health Work Workload Writing adjudication aged base caN protocol cancer prevention caucasian American cerebrovascular cohort college computerized cost cysteine rich protein day design eligible participant ethnic difference experience falls follow-up geographic difference high school human subject impression improved information gathering innovation instrument interest lung basal segment macroalbuminuria male medical schools member migration mortality novel novel strategies parent project payment pill prevention clinical trial programs prospective prothrombin fragment 1 racial difference repository research study response sample collection sex size success therapy design time interval tool trend willingness

项目摘要

The "Stroke Belt" is an area in the Southeastern US with stroke mortality rates approximately 25% above the rest of the nation, and contains a region of even higher stroke mortality (the "Stroke Buckle"). Also, African American stroke mortality is 50% higher than in whites. There are many hypotheses concerning these geographic and racial excesses in mortality, but little data to assess the causes. This proposal will address the lack of information at many levels. The role of geographic and racial differences in incidence and casefatality as contributors to differential mortality rates will be examined. Geographic and racial differences in the prevalence of a wide range of risk factors, and geographic and racial differences in the susceptibility to these factors, will be estimated. The impact of migration between regions will be evaluated. Finally, the role of candidate genes for stroke on the geographic and racial differences in stroke will be assessed. This study will recruit a nationwide cohort of 30,000 stroke-free participants over the age of 55. One-third (1/3) of the participants will be from the Stroke Belt, 1/3 from the Stroke Buckle, and 1/3 from the rest of the US. Within regions, 1/2 of the participants will be African American and 1/2 white and 1/2 male and 1/2 female. The risk factor status of participants will be established by a telephone interview, an inhome visit, and from GIS data. The cohort will be prospectively followed for 3 years for incident stroke events. This prospective cohort design offers many advantages including the direct assessment of incidence and case-fatality, and permitting the assessment of the role of risk factors that were evaluated prior to the stroke event. This study addresses the wide range of hypothesized causes of the excess stroke mortality in the Southeastern US and among African Americans, and will provide information to design interventions to reduce the excess stroke mortality in these populations.

“中风带”是美国东南部的一个中风多发地区，死亡率约25%以上的其他国家，并包含一个中风死亡率甚至更高的地区（“中风扣”）。此外，非洲美国人的中风死亡率比白人高50%。有很多关于这些地理和种族死亡率过高的假设，但几乎没有数据来评估原因。该提案将解决缺乏信息在多个层面。地理和种族差异的作用发病率和死亡率作为造成不同死亡率的因素，接受检查。广泛流行的地理和种族差异一系列的风险因素，以及地理和种族差异，对这些因素的敏感性，将被估计。移徙的影响将对各地区进行评估。最后，候选基因的作用将对卒中的地理和种族差异进行评估。这项研究将在全国范围内招募30，000名无中风参与者 55岁以上的人三分之一（1/3）的参与者将来自中风带，1/3从中风扣，1/3从美国其他地区。内 1/2的参与者将是非洲裔美国人，1/2的白色和1/2的男性和1/2女性。将确定参与者的风险因素状况通过电话访谈、入户访问和GIS数据。则将队列前瞻性随访3年，以了解卒中事件。这前瞻性队列设计提供了许多优势，包括直接评估发病率和病死率，并允许评估在卒中事件之前评估的风险因素的作用。本研究讨论了中风死亡率过高的各种假设原因在美国东南部和非洲裔美国人中，设计干预措施以降低过度卒中死亡率的信息这些人口。