DALLAS, Jan. 9 -- People who are Hispanic are more likely than whites and Native Americans to develop hemorrhagic strokes, caused by rupture of a brain artery, rather than ischemic strokes, caused by blockage of a brain artery, according to a new study appearing in Stroke: Journal of the American Heart Association.
Hemorrhage (bleeding) in the brain was more prevalent in Hispanics. Bleeding strokes occurred in 48 percent of Hispanics compared to 37 percent of whites and 27 percent of Native Americans.
The study is one of the largest to examine differences in stroke among minority populations. It included 1,290 whites, 242 Hispanics, 83 Native Americans, and 101 other patients hospitalized for stroke at the Barrow Neurological Institute in Phoenix, Arizona.
The authors observed that although Hispanics in the general population are less prone to high blood pressure than whites or Native Americans, Hispanics with stroke appear to have the greatest proportion of high blood pressure of any of the three groups. In this study, the rate of high blood pressure in stroke was reinforced. All groups had a high incidence of high blood pressure. It was found in 72 percent of Hispanics with stroke, compared to 71 percent of Native Americans and 66 percent of whites. Possible reasons for the high proportion of high blood pressure in Hispanics with stroke include less compliance with blood pressure treatment (especially in Hispanic Males) and special susceptibility of brain arteries to damage from high blood pressure in Hispanics.
Hispanics also had the second highest proportion of heavy alcohol intake and the second highest proportion of diabetes (behind Native Americans in these categories), both of which are known risk factors for stroke.
Whites ranked highest for heart disease and cigarette smoking and had the highest prevalence of cardioembolic strokes -- caused by blood clots that form within the heart and travel to the brain.
Native Americans were most likely to be diabetic and develop lacunar strokes -- caused by blockage of the smaller arteries of the brain.
The study's lead author, James L. Frey, M.D., chief, neurovascular section, division of neurology at the Barrow Neurological Institute, cautions that "because our data comes from a population of patients hospitalized at a single institution, broad generalizations may be hazardous without confirmation from larger community-based studies. Nonetheless, our data are consistent with other data about the differences in the prevalence of stroke risk factors and stroke types between these populations. Interestingly, the different populations appear to respond to risk factors similarly, which means that efforts to prevent stroke in Hispanics and Native Americans should emphasize control of risk factors in the same way as is suggested for whites."
Co-researchers include Heidi K. Jahnke, R.N., R.S.N., and Eric Bulfinch, Ed.D.
Stroke: Journal of the American Heart Association is one of five journals published by the Dallas-based AHA.
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