Incidence and risk factors for stroke in American Indians: the Strong Heart Study.
Incidence and risk factors for stroke in American Indians: the Strong Heart Study.
复制标题
DOI：
10.1161/circulationaha.108.772285
复制
发表时间：
2008-10-07
期刊：
影响因子：
37.8
通讯作者：
Lee ET
中科院分区：
文献类型：
--
作者：
Zhang Y;Galloway JM;Welty TK;Wiebers DO;Whisnant JP;Devereux RB;Kizer JR;Howard BV;Cowan LD;Yeh J;Howard WJ;Wang W;Best L;Lee ET
关于美洲印第安人致命和非致命中风发病率的已发表数据很少。这项观察性研究的目的是确定美洲印第安人中风的发生率和中风危险因素。本报告以 4549 名年龄在 45-74 岁之间的强心脏研究参与者为基础，该研究是针对不同美洲印第安人群体心血管疾病及其危险因素的最大的纵向、基于人群的研究。在 1989 年至 1992 年的基线检查中，42 名参与者（1132/100,000，根据 1990 年美国成年人口的年龄和性别分布进行调整）患有中风。截至 2004 年 12 月，4507 名既往没有中风史的参与者中，有 306 名（6.8%）首次中风，平均年龄为 66.5 岁。年龄和性别调整后的发病率为 679/100, 000 人年。 86% 的中风参与者发生非出血性脑梗塞； 14% 患有出血性中风。首次卒中后经年龄调整的 30 天总体病死率为 18%，一年病死率为 32%。年龄、舒张压、空腹血糖、糖化血红蛋白、吸烟、蛋白尿、高血压、高血压前期和糖尿病是脑卒中的危险因素。与美国白人和黑人相比，美洲印第安人中风的发病率更高。美洲印第安人首次中风的病死率也高于同年龄段的美国白人或黑人。我们的研究结果表明，控制血压和血糖以及避免吸烟可能是预防该人群中风的重要途径。
There are few published data on the incidence of fatal and non-fatal stroke in American Indians. The aims of this observational study were to determine the incidence of stroke and stroke risk factors among American Indians. This report is based on 4549 participants aged 45–74 at enrollment in the Strong Heart Study, the largest longitudinal, population-based study of cardiovascular disease and its risk factors in a diverse group of American Indians. At baseline examination in 1989–1992, 42 participants (1132/100,000, adjusted to the age and sex distribution of the U.S. adult population in 1990) had prevalent stroke. Through December 2004, 306 (6.8%) of 4507 participants without prior stroke suffered a first stroke at a mean age of 66.5 years. The age- and sex-adjusted incidence was 679/100, 000 person-years. Non-hemorrhagic cerebral infarction occurred in 86% of participants with incident strokes; 14% suffered hemorrhagic stroke. Overall age-adjusted 30-day case-fatality from first stroke was 18%, with a one-year case-fatality of 32%. Age, diastolic blood pressure, fasting glucose, HbA1C, smoking, albuminuria, hypertension, pre-hypertension and diabetes were risk factors of incident stroke. Compared to U.S. white and black populations, American Indians have a higher incidence of stroke. The case-fatality rate for first stroke is also higher in American Indians than in the U.S. white or black population in the same age range. Our findings suggest that blood pressure and glucose control and smoking avoidance may be important avenues for stroke prevention in this population.