Sleep apnea health disparities in Mexican American stroke patients

描述(申请人提供)：中风是美国成年人致残的主要原因，也是导致死亡的主要原因。墨西哥裔美国人(MA)是拉美裔美国人中最大的一个亚群，他们的中风风险比欧洲美国人高得多，特别是在风险高出一倍以上的年轻人群中。考虑到更大的风险和更早的发病，中风的影响不成比例地由MA经历。多发性硬化患者中风风险增加的原因尚不清楚。超过一半的缺血性中风患者患有睡眠呼吸暂停，这是中风的一个非常常见和重要的危险因素，也是导致不良中风结局的潜在危险因素。目前还没有已发表的研究确定睡眠呼吸暂停在MAS中的流行程度，以确定睡眠呼吸暂停对这一人群过度中风负担的贡献。在学术医学中心进行的小型研究表明，患有睡眠呼吸暂停的中风患者的中风结果特别差，但缺乏针对不同人群的基于人群的研究。目前的应用程序寻求调查与中风患者睡眠呼吸暂停相关的健康差异，以了解中风患者明显的种族差异。这项研究将为预防或治疗睡眠呼吸暂停综合征的干预措施的发展提供信息，这将减少种族中风的差异。该项目的母公司研究，科珀斯克里斯蒂的脑攻击监测(BASIC)项目，是一项正在进行的基于人群的中风监测研究，确定了德克萨斯州努塞斯县的中风病例。这项研究在拉美裔美国人中风方面取得了许多重要发现。Basic将继续识别Nueces县的所有中风，直到当前应用程序的第三年年中，并将提供详细的90天中风结果数据，直到第二年年中。目前的应用程序将把基本数据收集延长到第五年第三个月，并将增加：(1)急性中风期间的睡眠呼吸暂停筛查，区分阻塞性和中心性事件，(2)睡眠呼吸暂停病例的睡眠呼吸暂停筛查，(3)获得睡眠呼吸暂停的护理措施，以及(4)基因混合分析，以研究遗传学如何与睡眠呼吸暂停的种族差异有关。该应用程序寻求以成本控制的方式了解和补救非常频繁的风险因素睡眠呼吸暂停对常见的破坏性疾病中风的影响，中风是美国少数民族人口最多、增长最快的疾病。

DESCRIPTION (provided by applicant): Stroke is the leading cause of adult disability in the US and a leading cause of death. Mexican Americans (MA), the largest subgroup of Hispanic Americans, have a substantially higher stroke risk than European Americans, especially at younger ages where the risk is more than double. Given the greater risk and earlier onset, the impact of stroke is disproportionately experienced by MAs. Reasons for increased stroke risk in MAs are poorly understood. More than half of ischemic stroke patients have sleep apnea, a very common and important risk factor for stroke and potentially a risk factor for poor stroke outcome. No published studies have established the prevalence of sleep apnea in MAs to discern sleep apnea's contribution to excess stroke burden in this population. Small studies conducted in academic medical centers have suggested that stroke patients with sleep apnea have particularly poor stroke outcomes, but population-based studies in diverse populations are lacking. The current application seeks to investigate health disparities related to sleep apnea in stroke patients in order to understand the marked ethnic differences in stroke. This research will inform the development of interventions to prevent or treat sleep apnea in MAs, which will reduce the ethnic stroke disparity. The parent study for this project, the Brain Attack Surveillance in Corpus Christi (BASIC) project, is an ongoing population-based stroke surveillance study that identifies stroke cases in Nueces County, Texas. This study has made many important discoveries about stroke in Hispanics. BASIC will continue to identify all strokes in Nueces County until mid year 3 of the current application and will provide detailed 90-day stroke outcome data until mid year 2. The current application will extend BASIC data collection through year 5 month 3 and will add: (1) sleep apnea screening in the acute stroke period that differentiates obstructive from central events, (2) sleep apnea screening for intracerebral hemorrhage cases, (3) access to care measures for sleep apnea, and (4) genetic admixture analysis to investigate how genetics may relate to ethnic disparities in sleep apnea. The application seeks, in a cost-containing fashion, to understand and remedy the influence of a very frequent risk factor, sleep apnea, on a common, devastating disease, stroke, in the largest and fastest growing US minority population.