Sleep apnea health disparities in Mexican American stroke patients

描述（由申请人提供）：中风是美国成人残疾的主要原因，也是死亡的主要原因。墨西哥裔美国人（MA）是西班牙裔美国人中最大的亚群，其中风风险远高于欧洲裔美国人，尤其是在年轻时，风险是其两倍多。由于风险更大且发病更早，MA经历的卒中影响不成比例。MA患者卒中风险增加的原因尚不清楚。超过一半的缺血性卒中患者患有睡眠呼吸暂停，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了睡眠呼吸暂停在MA中的患病率，以辨别睡眠呼吸暂停对该人群过度卒中负担的贡献。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局特别差，但缺乏在不同人群中进行的基于人群的研究。本申请寻求调查中风患者中与睡眠呼吸暂停相关的健康差异，以了解中风中的显著种族差异。这项研究将为预防或治疗MA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。该项目的母研究，即Corpus Christi（BASIC）项目中的脑攻击监测，是一项正在进行的基于人群的卒中监测研究，该研究确定了德克萨斯州Nueces县的卒中病例。这项研究在西班牙裔中风方面有许多重要发现。BASIC将继续识别Nueces县的所有卒中，直到当前申请的第3年中期，并将提供详细的90天卒中结局数据，直到第2年中期。目前的应用程序将基本数据收集扩展到第5年第3个月，并将增加：（1）急性卒中期间的睡眠呼吸暂停筛查，以区分阻塞性事件和中枢性事件，（2）脑出血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）遗传混合分析，以调查遗传学如何与睡眠呼吸暂停的种族差异相关。该申请旨在以包含成本的方式了解和补救一种非常常见的风险因素睡眠呼吸暂停对最大和增长最快的美国少数民族人口中常见的毁灭性疾病中风的影响。

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.