The study, led by University of Michigan researchers and released today at the 28th International Stroke Conference in Phoenix, Arizona, is based on 808 interviews with Mexican American and non-Hispanic white stroke subjects in the ethnically diverse Corpus Christi area of Texas.
The effort is part of the nation's only major study of stroke in Mexican Americans, the largest sub-group of the Hispanic population that is now the largest minority population in the United States.
The results show significant differences between the two groups in conditions that increase the risk of stroke, like diabetes; use of preventive measures such as blood-thinning drugs; access to care; and general characteristics of age, education, and income.
Understanding these differences in stroke risk, access to care, and demographics could help stroke-prevention campaigns tailor their approaches to the Hispanic community and increase their effectiveness, the researchers say.
"The effort to reduce stroke's impact on the Hispanic population must mean more than simply translating brochures into Spanish," says senior author Lewis Morgenstern, M.D., director of the U-M Stroke Program and associate professor of neurology. "We must look at the role that acculturation plays, especially issues of understanding and trust of the health care system, and social factors."
The results are from the five-year, $2.5 million BASIC, or Brain Attack Surveillance in Corpus Christi, study. BASIC aims to answer important questions about how common stroke is in the Hispanic community, and what factors influence the rates of stroke and stroke death. Morgenstern began the study in 1999 while he was at the University of Texas-Houston Medical School, and is continuing it at the U-M.
Project manager Melinda Smith Cox, M.P.H., who will discuss the findings at a Feb. 14 press briefing, says, "It's crucial that we understand this population's special issues so we can incorporate them into stroke prevention and treatment programs."
About 730,000 Americans suffer strokes each year. Stroke is the nation's third leading cause of death, killing more than 160,000 American each year; it is also the leading cause of disability. More than 4.5 million Americans are stroke survivors.
The researchers obtained their data by interviewing 323 Mexican Americans and 340 non-Hispanic whites who had had strokes in Corpus Christi during the years 2000 and 2001.
The effort was part of the BASIC study's overall approach of passive and active stroke surveillance in hospitals and nursing homes in the city and surrounding area of 300,000 residents, who are almost equally divided between Mexican-Americans and non-Hispanic whites. BASIC is funded by the National Institute of Neurological Diseases and Stroke, part of the National Institutes of Health.
Interviews were conducted in English or Spanish, according to patient preference. Fifty-four percent of the Mexican American patients said they preferred to use Spanish in everyday life, and 33 percent had little or no English skills.
The analysis found many statistically significant differences between the two groups. The Mexican-Americans were younger than the non-Hispanic whites, with an average age of 69.9 as opposed to 75.3. The Mexican-Americans were also less likely to have graduated from high school and more likely to earn less than $20,000 per year.
They were also more likely than the non-Hispanic whites to have diabetes, which significantly raise the risk of stroke, but they were less likely to have atrial fibrillation, a heart-rhythm disorder that also increases stroke risk.
Mexican-Americans in the study who had a stroke previously were less likely than non-Hispanic whites to be taking blood-thinning drugs that can reduce the risk of repeated stroke by preventing clot formation. There were no differences in medication use among patients who had high blood pressure or diabetes.
There were also no differences between the two populations in alcohol use, smoking status, or rate of having a regular primary care physician.
Morgenstern and Cox intend to continue analyzing and compiling data from the study to look for more patterns that might help them and others understand what factors influence stroke risk among Hispanics. And, they and their colleagues will continue working on the study of stroke patterns among Mexican Americans and non-Hispanic whites in Corpus Christi, which will give important data on stroke incidence in this sub group of the Hispanic population.
Contact:
Krista Hopson, khopson@umich.edu, or
Carrie Hagen, carriehh@umich.edu
734-764-2220