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Title: | Stroke in Indigenous Africans, African Americans, and European Americans Interplay of Racial and Geographic Factors |
Authors: | Owolabi, Mayowa Sarfo, Fred Stephen Howard, Virginia J. Irvin, Marguerite R. Gebregziabher, Mulugeta Akinyemi, Rufus Bennett, Aleena Armstrong, Kevin Tiwari, Hemant K. Akpalu, Albert...et.al. |
Keywords: | Case–control study Cohort study Death Risk factors Stroke |
Issue Date: | 2017 |
Publisher: | Stroke |
Citation: | Stroke. 2017;48:1169-1175. DOI: 10.1161/STROKEAHA.116.015937 |
Abstract: | Background and Purpose—The relative contributions of racial and geographic factors to higher risk of stroke in people
of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among
indigenous Africans (IA), African Americans (AA), and European Americans (EA).
Methods—SIREN (Stroke Investigative Research and Educational Network) is a large multinational case–control study in West
Africa—the ancestral home of 71% AA—whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke)
is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we
compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies.
Results—There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3
years, respectively (P<0.0001). Hemorrhagic stroke was more frequent among IA (27%) compared with AA (8%) and
EA (5.4%; P<0.001). Lacunar strokes were more prevalent in IA (47.1%), followed by AA (35.1%) and then EA (21.0%;
P<0.0001). The frequency of hypertension in decreasing order was IA (92.8%), followed by AA (82.5%) and then EA
(64.2%; P<0.0001) and similarly for diabetes mellitus IA (38.3%), AA (36.8%), and EA (21.0%; P<0.0001). Premorbid
sedentary lifestyle was similar in AA (37.7%) and EA (34.0%) but lower frequency in IA (8.0%).
Conclusions—Environmental risk factors such as sedentary lifestyle may contribute to the higher proportion of ischemic stroke
in AA compared with IA, whereas racial factors may contribute to the higher proportion of hypertension and diabetes mellitus
among stroke subjects of African ancestry. |
Description: | An article published in Stroke. 2017;48:1169-1175. DOI: 10.1161/STROKEAHA.116.015937 |
URI: | http://hdl.handle.net/123456789/13441 |
Appears in Collections: | College of Health Sciences
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