We seek to continue our population-based study of stroke incidence, risk factors, treatment, and outcome of stroke within our biracial metropolitan population of 1,349,351, of whom 215,611 (15%) are of black race (US Census 2000). We have studied trends in stroke incidence and case fatality, as well as the prevalence of risk factors and knowledge of stroke (via a population survey) for almost 15 years and have demonstrated a racial disparity where stroke incidence in African-Americans is more than double that of whites. In addition to continuing these important activities, we propose an innovative pilot study that will be the largest prospective, population-based stroke outcomes study to date. The anticipated ~3,200 patients with strokes and 800 TIAs from our region in 2010, as well as the 2,000 surveyed participants, will be used to test the following hypotheses: 1. Temporal trends in the incidence rate of stroke will demonstrate a decrease over time in whites (as shown by our 2005 preliminary data). However, there will not be a similar decrease among blacks, a racial group that has not been examined in other temporal studies of stroke. We expect that case fatality rates will not change between periods, and will be similar for both blacks and whites. 2. A cohort of subjects followed by a regional HIE combined with phone-call follow-up will be more representative of the entire stroke population in our region than a cohort of subjects that agree to in-person interviews, which is likely to have participation and survival biases. Information obtained via this approach will be as valid as data from manual chart abstraction and direct interview for determining access to care and individual patients'functional outcome after stroke across a region, and will be more efficient to collect than that obtained via manual processes. 3. The proportion of the population that knows warning signs or risk factors for stroke will NOT improve between 2006 and 2011, based on our preliminary data. When subjects are asked about their own personal risk for stroke, a lower self-perceived risk will be associated with worse stroke knowledge.

Public Health Relevance

The change in stroke occurrence over time is the ultimate test of how well science has translated new discoveries into benefits for the population. Our study has examined racial disparities in stroke over the last 15 years, showing that blacks have higher risk for stroke than whites. In our population, the occurrence of stroke is decreasing in whites but not African Americans, and we will continue to describe trends in stroke occurrence, cause, treatment, and outcome in a biracial metropolitan population.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
5R01NS030678-18
Application #
8084183
Study Section
Neurological, Aging and Musculoskeletal Epidemiology (NAME)
Program Officer
Moy, Claudia S
Project Start
1992-09-22
Project End
2014-06-30
Budget Start
2011-07-01
Budget End
2012-06-30
Support Year
18
Fiscal Year
2011
Total Cost
$1,188,109
Indirect Cost
Name
University of Cincinnati
Department
Neurology
Type
Schools of Medicine
DUNS #
041064767
City
Cincinnati
State
OH
Country
United States
Zip Code
45221
Yeramaneni, Samrat; Kleindorfer, Dawn O; Sucharew, Heidi et al. (2017) Hyperlipidemia is associated with lower risk of poststroke mortality independent of statin use: A population-based study. Int J Stroke 12:152-160
Katz, Brian S; Adeoye, Opeolu; Sucharew, Heidi et al. (2017) Estimated Impact of Emergency Medical Service Triage of Stroke Patients on Comprehensive Stroke Centers: An Urban Population-Based Study. Stroke 48:2164-2170
Madsen, Tracy E; Khoury, Jane C; Alwell, Kathleen A et al. (2017) Sex differences in cardiovascular risk profiles of ischemic stroke patients with diabetes in the Greater Cincinnati/Northern Kentucky Stroke Study. J Diabetes :
Wrigley, Peter; Khoury, Jane; Eckerle, Bryan et al. (2017) Prevalence of Positive Troponin and Echocardiogram Findings and Association With Mortality in Acute Ischemic Stroke. Stroke 48:1226-1232
Mackey, Jason; Khoury, Jane C; Alwell, Kathleen et al. (2016) Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population. Neurology 87:2192-2197
Madsen, Tracy E; Khoury, Jane; Cadena, Rhonda et al. (2016) Potentially Missed Diagnosis of Ischemic Stroke in the Emergency Department in the Greater Cincinnati/Northern Kentucky Stroke Study. Acad Emerg Med 23:1128-1135
McCarthy, Michael J; Sucharew, Heidi J; Alwell, Kathleen et al. (2016) Age, subjective stress, and depression after ischemic stroke. J Behav Med 39:55-64
Torabi, Elham; Froehle, Craig M; Lindsell, Christopher J et al. (2016) Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine. Acad Emerg Med 23:55-62
Madsen, Tracy E; Sucharew, Heidi; Katz, Brian et al. (2016) Gender and Time to Arrival among Ischemic Stroke Patients in the Greater Cincinnati/Northern Kentucky Stroke Study. J Stroke Cerebrovasc Dis 25:504-10
Anderson, Christopher D; Falcone, Guido J; Phuah, Chia-Ling et al. (2016) Genetic variants in CETP increase risk of intracerebral hemorrhage. Ann Neurol 80:730-740

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