Abstract TMP59: Interplay of Racial and Geographical Differences in Stroke Type and Risk Factors Among Indigenous West Africans; African Americans and European Americans

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mayowa Owolabi ◽  
George Howard ◽  
Mulugeta Gebregziabher ◽  
Fred Sarfo ◽  
Ryan Irvin ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
African Ancestry ◽  
The United States ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Geographical Differences ◽  
European Americans ◽  
Regards Study ◽  
Stroke Type

Introduction: The relative contributions of racial and environmental factors to the higher risk of stroke in people of African ancestry are not clear due to limited opportunities to evaluate stroke type and risk among indigenous Africans, in comparison with Africans in diaspora and their host populations. This knowledge could provide insights into avenues for similar vs. unique approaches to managing stroke risk in Africans. Objective: To compare the pattern of stroke and contribution of vascular risk factors to stroke among indigenous Africans, African Americans and European Americans. Methods: SIREN is a large multicenter case-control study involving several sites in West Africa, the ancestral home of 71% African Americans, whilst REGARDS is a cohort study including African and European Americans in the United States. Stroke diagnosis and type were confirmed using CT or MRI scan. Traditional vascular risk factors were assessed using history, physical examination and laboratory investigations. We compared data from acute stroke cases age≥55 years in SIREN and REGARDS in the distribution of key socio-demographic and clinical risk factors based on harmonized standard definitions. Results: There were 811 stroke subjects in the SIREN population (A) and 452 African Americans (B) and 665 European Americans (C) from the REGARDS study with a progressive increment in mean age of 68.0 ± 9.3, 73.0 ± 8.3 and 76.0 ± 8.3 years respectively, p<0.0001. Hemorrhagic stroke occurred in 291/811 (27.0%), 36/452 (8.0%) and 36/665 (5.4%), in A, B, and C (p < 0.001) respectively. There were significant differences in prevalence of vascular risk factors among the three groups namely hypertension: 92.8%, 82.5% & 64.2%, p<0.01; mean LDL cholesterol (mg/dl): 121±52, 116±32, 110±33 (p< 0.03); cardiac diseases: 12.5%, 25.0% & 31.7% (p< 0.01); sedentary lifestyle:8%, 37.7% and 34.0% (p<0.001); and 2.0%, 18.3% & 14.4% were current smokers in A, B and C respectively (p<0.001). Conclusion: Environmental risk factors such as cigarette smoking may contribute to the higher proportion of ischemic stroke in African-Americans compared to indigenous Africans, while racial factors may contribute to the higher proportion of hypertension among stroke subjects of African ancestry.

P2-115: Influence of vascular risk factors on cognitive performance in community-dwelling African Americans

2008 ◽  
Vol 4 ◽  
pp. T405-T405
Author(s):  
Christine M. Khosropour ◽  
N. Maritza Dowling ◽  
Whitney Wharton ◽  
Dorothy F. Edwards ◽  
Cynthia M. Carlsson ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Cognitive Performance ◽  
Vascular Risk Factors ◽  
Community Dwelling ◽  
Vascular Risk

Awareness, treatment, and control of vascular risk factors in African Americans with stroke

Neurology ◽  
2003 ◽  
Vol 60 (1) ◽  
pp. 64-68 ◽  
Author(s):  
S. Ruland ◽  
R. Raman ◽  
S. Chaturvedi ◽  
S. Leurgans ◽  
P. B. Gorelick
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
And Control

Abstract TP166: The Topmost Modifiable Risk Factors for Stroke Among People of African Ancestry

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mayowa O Owolabi ◽  
Fred S Sarfo ◽  
Onoja Akpa ◽  
Mulugeta Gebregziabher ◽  
Rufus Akinyemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Ancestry ◽  
Vascular Risk Factors ◽  
Systematic Evaluation ◽  
Modifiable Risk Factors ◽  
Large Artery ◽  
Vascular Risk ◽  
Geographical Variations ◽  
Catchment Areas ◽  
The Impact

Background: Regional and geographical variations exist in stroke burden and risk factor distribution. The unique and dominant risk factors for stroke among people of African ancestry where the burden of stroke is escalating, are poorly understood. Such information is crucial in prioritizing tailor-made interventions to tackle the menace of stroke in developing countries. Purpose: We aimed to identify and quantify the contributions of the topmost modifiable risk factors for stroke occurrence in people of African ancestry within the context of the Stroke Investigative Research and Educational Network (SIREN), the largest study of stroke in Africa. Methods: The SIREN study is an ongoing, multicenter, case-control study involving several sites in Nigeria and Ghana. Cases included adults aged >18 years with first clinical stroke within 8 days of current symptom onset with CT scan confirmation. Controls were stroke-free adults, mostly from the communities in the catchment areas of the SIREN hospitals where cases were recruited. A systematic evaluation of traditional vascular risk factors as well as lifestyle and behavioral factors were assessed for cases and controls. Results: 1,638 cases and 1,653 controls with mean ages of 58.52 and 57.76 years respectively were recruited. Ischemic and hemorrhagic stroke types constituted 62.4% and 36.1% of stroke respectively. Among ischemic stroke subjects, 45.7%, 36.3%, 13.6%, 1.0% and 3.4% had small-vessel, large-artery atherosclerosis, cardio-embolic, others and unknown subtypes according to the TOAST classification. Leading vascular risk factors identified among stroke subjects compared with controls were hypertension- 79.3% vs 34.6%, p<0.001; Dyslipidemia 20.8% vs 6.6%, p<0.001; Diabetes mellitus- 24.4% vs 12.8% and history of cardiac diseases 15.4% vs 7.9%, p<0.001. Adjusted ORs (95% CI) for hypertension, dyslipidemia, cardiac disease and diabetes among stroke subjects compared with controls were 6.43 (5.84-7.54), 2.08 (1.61-2.69), 1.48 (1.15-1.91) and 1.29 (1.05-1.60) respectively. Conclusion: Implementation of interventions towards mitigating the impact of vascular risk factors at the population level would be essential in curtailing the growing burden of stroke in Africans.

scholarly journals Acute Cerebrovascular Events in Hospitalized COVID-19 Patients

Stroke ◽  
2020 ◽  
Vol 51 (9) ◽  
Author(s):  
Aaron Rothstein ◽  
Olivia Oldridge ◽  
Hannah Schwennesen ◽  
David Do ◽  
Brett L. Cucchiara
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Intracranial Hemorrhage ◽  
Significant Risk ◽  
The United States ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Incidence ◽  
Cerebrovascular Events ◽  
History Of

Background and Purpose: Initial reports suggest a significant risk of thrombotic events, including stroke, in patients hospitalized with coronavirus disease 2019 (COVID-19). However, there is little systematic data on stroke incidence and mechanisms, particularly in racially diverse populations in the United States. Methods: We performed a retrospective, observational study of stroke incidence and mechanisms in all patients with COVID-19 hospitalized from March 15 to May 3, 2020, at 3 Philadelphia hospitals. Results: We identified 844 hospitalized patients with COVID-19 (mean age 59 years, 52% female, 68% Black); 20 (2.4%) had confirmed ischemic stroke; and 8 (0.9%) had intracranial hemorrhage. Of the ischemic stroke patients, mean age was 64 years, with only one patient (5%) under age 50, and 80% were Black. Conventional vascular risk factors were common, with 95% of patients having a history of hypertension and 60% a history of diabetes mellitus. Median time from onset of COVID symptoms to stroke diagnosis was 21 days. Stroke mechanism was cardioembolism in 40%, small vessel disease in 5%, other determined mechanism in 20%, and cryptogenic in 35%. Of the 11 patients with complete vascular imaging, 3 (27%) had large vessel occlusion. Newly positive antiphospholipid antibodies were present in >75% of tested patients. Of the patients with intracranial hemorrhage, 5/8 (63%) were lobar intraparenchymal hemorrhages, and 3/8 (38%) were subarachnoid hemorrhage; 4/8 (50%) were on extracorporeal membrane oxygenation. Conclusions: We found a low risk of acute cerebrovascular events in patients hospitalized with COVID-19. Most patients with ischemic stroke had conventional vascular risk factors, and traditional stroke mechanisms were common.

Abstract WP450: Cognitive Impairment and Asymptomatic Intracranial Atherosclerotic Stenosis in General Population

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
M.Fareed K. Suri ◽  
Jincheng Zhou ◽  
Ye Qiao ◽  
Haitao Chu ◽  
Adnan I Qureshi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
African Americans ◽  
Previous History ◽  
Vascular Risk Factors ◽  
Intracranial Atherosclerosis ◽  
Vascular Risk ◽  
Atherosclerosis Risk In Communities ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis

Background: There is growing evidence suggesting that intracranial atherosclerosis is associated with cognitive impairment. We investigated the association between asymptomatic intracranial atherosclerosis and cognitive impairment in the bi-racial Atherosclerosis Risk in Communities (ARIC) cohort. Methods: ARIC participants who underwent high-resolution 3T magnetic resonance angiography, and a neuropsychology battery and neurological examination adjudicated by an expert panel, to detect mild cognitive impairment (MCI) and dementia. We adjusted for demographic and vascular risk factors in weighted logistic regression analysis, accounting for stratified sampling design and attrition, to determine the association of intracranial atherosclerotic stenosis (ICAS) with cognitive impairment. Results: In 1705 participants (mean age 76 ± 5.3, 41% men, 71% Whites and 29% African-Americans) with adequate imaging quality and no previous history of stroke, MCI was identified in 578 (34%) and dementia in 79 (4.6%). In white participants, after adjustment for demographic and vascular risk factors, ICAS ≥50% (vs no ICAS) was strongly associated with dementia (odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7-10) and with any-cognitive impairment (OR 1.7, 95% CI 1.06 - 2.8). In contrast, no association was found between ICAS ≥50% and MCI or dementia in African-Americans, though sample size was limited and estimates were imprecise. Conclusion: Our results suggest asymptomatic ICAS is independently associated with cognitive impairment and dementia in Whites

Abstract P884: Differences in Stroke Type and Stroke Risk Factors Between African Americans and Ghanaian Stroke Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Esther Olasoji ◽  
FRED S SARFO ◽  
Alexis Simpkins
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Stroke Risk ◽  
Country Of Origin ◽  
Multivariate Regression Analysis ◽  
The United States ◽  
Rural Setting ◽  
Stroke Risk Factors ◽  
Ancestral Lineage ◽  
Stroke Type

Introduction: Ancestral lineage of many African Americans (AA) includes West African descent. Previous research has shown a higher prevalence of cardiovascular risk factors such as hypertension and diabetes mellitus (DM) in AA compared to other racial groups in the United States (US). Some have attributed these differences in the US population to ancestral lineage of the AA population. We sought to compare the stroke type and stroke risk factors between AA and Ghana, a country in West Africa. Methods: Data from the UFHealth institutional stroke database and the Kumasi, Ghana Stroke Survivors Registry between 01/2014 and 11/2019 provided a dataset of adult patients diagnosed with stroke from both locations. Multivariate regression analysis identified differences between country of origin, race, stroke type and clinical factors. Results: Among the 5519 patients, the median age was 66 (IQR 45 - 87), 49% woman, 16% AA, 19% Ghanaian, and 66% non-Hispanic white. In the total population, 22% had an intracerebral hemorrhage, 69% ischemic stroke, and 9% subarachnoid hemorrhage. Compared to patients in the U.S., patients from Ghana were younger (OR 1.06, 1.05-1.06 95% CI); more likely female (OR 1.66, 1.0-1.97 95% CI), hypertensive (OR 8.87, 6.46-12.17 95%CI), and more likely to consume alcohol (OR 4.25, 3.32-5.44 95% CI). Ghanaians were less likely to have DM (OR 0.81, 0.66-0.99 95% CI), smoke (OR 0.10, 0.07-0.13 95% CI), and live in an urban vs rural setting (OR 0.84, 0.71-0.99 95% CI). Compared to AA specifically, Ghanaians were younger (OR 1.02, 1.01-1.03 95% CI); more likely female (OR 1.45, 1.15-1.81 95% CI), hypertensive (OR 4.66, 3.25-6.68 95%CI), more likely to consume alcohol (OR 3.68, 2.62-5.18 95% CI); less likely to have DM (OR 0.55, 0.43-0.71 95% CI), smoke (OR 0.13, 0.08-0.19 95% CI), and less likely live in an urban vs rural setting (OR 0.66, 0.53-0.82 95% CI). Conclusion: Significant differences were found between stroke risk factors (hypertension, DM, alcohol consumption, and smoking) and race as well as country of origin. Further study of social and environmental differences between groups may elucidate the differences in stroke risk factors between AA’s and West Africans.

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