Comparison of Hemorrhagic & Ischemic Stroke Among Blacks and Whites

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PROJECT SUMMARY: We seek to continue our population-based study of stroke incidence and case fatality, prevalence of risk factors, stroke treatment, and post-stroke outcomes within a biracial metropolitan population of 1,368,604 of whom 223,417 (16.3%) are of black race (US Census 2010). We expect to identify ~4500 physician confirmed and well characterized stroke events (projected 2900 ischemic strokes, 525 hemorrhagic strokes, and 1075 transient ischemic attack [TIA]) among residents of the five-county Greater Cincinnati/Northern Kentucky (GCNK) region at all 20 regional hospitals/EDs for the period 7/1/2019 to 12/31/2020, as well as 2,000 survey participants. For almost 25 years, we have studied trends in stroke incidence and case fatality and have demonstrated a racial disparity where stroke incidence in African-Americans is more than double that of whites. In each prior study period, we have also examined the prevalence of risk factors (and knowledge of stroke) via a population survey in order to put our temporal trend findings into context. In addition to continuing these important activities, we also examined stroke recurrence in a population- based fashion in our prior study period, finding that blacks were more likely to have recurrent events than whites. We now seek to evaluate temporal trends in recurrence rates, and specifically racial disparities in those temporal trends. Previously we had piloted methods of obtaining a population-based outcome among stroke patients, and we are now ready to obtain outcomes after ischemic stroke across our entire population, data that are desperately needed in the field. Finally, we have used our data to inform eligibility for stroke clinical trials via a close collaboration with NIH StrokeNet and have shared our data with the scientific community for this purpose. By obtaining more detailed outcomes data, we will now be able to better inform proposed recovery and prevention trials as well.