Sleep apnea health disparities in Mexican American stroke patients

描述（由申请人提供）：中风是美国成年人残疾的主要原因，也是导致死亡的主要原因。墨西哥裔美国人（MA）是西班牙裔美国人中最大的亚群，其中风风险明显高于欧洲裔美国人，尤其是在年轻时，风险超过两倍。由于风险更大，发病更早，中风的影响不成比例地由MAs经历。MAs患者中风风险增加的原因尚不清楚。超过一半的缺血性卒中患者有睡眠呼吸暂停，这是卒中的一个非常常见和重要的危险因素，也是卒中预后不良的潜在危险因素。没有已发表的研究确定睡眠呼吸暂停在MAs中的患病率，以确定睡眠呼吸暂停对该人群卒中负担过重的贡献。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中风的结果特别差，但缺乏针对不同人群的基于人群的研究。本应用程序旨在调查卒中患者睡眠呼吸暂停相关的健康差异，以了解卒中的显着种族差异。本研究将为预防或治疗睡眠呼吸暂停的干预措施的发展提供信息，这将减少种族中风的差异。该项目的母体研究，科珀斯克里斯蒂脑梗死监测（BASIC）项目，是一项正在进行的以人群为基础的中风监测研究，旨在确定德克萨斯州Nueces县的中风病例。这项研究有许多关于西班牙裔中风的重要发现。BASIC将继续识别Nueces县的所有中风，直到当前应用的第三年中，并将提供详细的90天中风结果数据，直到第二年年中。目前的应用程序将扩展BASIC数据收集至第5个月3，并将增加：(1)在急性中风期间进行睡眠呼吸暂停筛查，以区分阻塞性和中枢性事件；(2)对脑出血病例进行睡眠呼吸暂停筛查；(3)获得睡眠呼吸暂停的护理措施；(4)基因混合分析，以调查基因如何与睡眠呼吸暂停的种族差异有关。该应用程序寻求以一种成本控制的方式，了解和补救一个非常常见的风险因素，睡眠呼吸暂停，对一种常见的，毁灭性的疾病，中风，在美国最大和增长最快的少数民族人口的影响。

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.