University of Minnesota-led study shows Hmong stroke patients are younger, other unique stroke patterns

MINNEAPOLIS/ST. PAUL (08/01/2023) — In a first-of-its-kind study published in the Journal of the American Heart Association, a University of Minnesota Medical School-led research team identified unique stroke patterns among Hmong Americans. The study found higher incidence of brain hemorrhage, hardening of the arteries of the brain and small vessel disease in Hmong stroke patients, compared to white stroke patients.

“Risk factors such as high blood pressure and diabetes are at the core of these conditions. Our study signals that some Hmong patients struggle to have control of these risk factors that impact their health,” said Haitham Hussein, MD, an associate professor at the U of M Medical School. “We need to engage with all communities of racial minorities, understand their culture, learn their struggles and partner with them in addressing health disparities.”

Previous studies have indicated high rates of cardiovascular disease and risk factors, but little was known about stroke in Hmong Americans. This study compared 128 Hmong patients admitted with stroke between 2010 and 2019 with more than 3,000 white stroke patients during the same time period. The research team found: 

• On average, Hmong patients were 11 years younger and had twice as high a rate of intracerebral hemorrhage—or bleeding within the brain tissue. 
• Among patients with ischemic stroke—which occurs due to clogging of an artery of the brain—Hmong patients came to the hospital four hours later and were less likely to use an ambulance. 
• Hmong patients with ischemic stroke had less frequent admissions to rehabilitation facilities despite having the same stroke severity.
• Among patients with either ischemic stroke or intracerebral hemorrhage, risk factors such as high blood pressure, diabetes and high cholesterol were worse among Hmong patients. 

The research team suggests larger studies to confirm these findings, as well as immediate action to close gaps in primary care and stroke health literacy. Dr. Hussein's team developed stroke educational material, including videos that feature survivors speaking Hmong or that are specifically adapted to the Hmong culture.

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This study is the first to examine stroke in the Hmong community. While there are two other published articles on stroke in the Hmong population, authored by Dr. Hussein, one focuses on Hmong health literacy related to stroke, and the other describes the process of adapting stroke education material for the Hmong community. Collectively, these studies provide valuable insights into stroke and its impact on the Hmong people, helping to develop better healthcare practices for this community.

About the University of Minnesota Medical School
The University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. We acknowledge that the U of M Medical School, both the Twin Cities campus and Duluth campus, is located on traditional, ancestral and contemporary lands of the Dakota and the Ojibwe, and scores of other Indigenous people, and we affirm our commitment to tribal communities and their sovereignty as we seek to improve and strengthen our relations with tribal nations. For more information about the U of M Medical School, please visit med.umn.edu.