We propose to use data from the National Health and Nutrifion Examinafion Survey (NHANES) to describe racial differences over time in patterns of traditional stroke risk factors, novel biologic and social risk factors for stroke, and stroke risk scores. To better understand racial differences in the association between both traditional and non-traditional biological and social risk factors and the mechanisms underiying these relationships, we propose to address the following aims using data from NHANES:
Aim 1 : To describe trends in prevalence and control of tradifional stroke risk factors in NHANES III (1988- 1994) and NHANES 1999-2010 and how the trends differ among whites, African Americans, and Mexican Americans.
Aim 2 : To describe trends in non-traditional social risk factors for stroke (e.g. neighborhood characteristics) and novel biologic stroke risk factors (e.g. hsCRP, fibrinogen, and Lp(a)) in NHANES III and NHANES 1999-2010 and how the trends differ by race/ethnicity.
Aim 3 : To describe trends in 10-year stroke risk, 10-year CVD risk, and allostatic load, an index of cumulative biologic risk, using NHANES III and NHANES 1999-2010 and how the trends differ by race/ethnicity.
Aim 4 : Among stroke survivors in NHANES III and NHANES 1999-2004, to examine the associafion between mortality and novel biologic and social risk factors, after adjustment for traditional risk factors. We will also explore racial/ethnic differences in these associations. The use of NHANES data allows for detailed assessments of stroke risk factors and outcomes linked to extensive treatment, biomarker, geographic, and mortality data in a representative sample of U.S. adults.
The proposed study will address gaps in our knowledge about racial/ethnic differences in trends in nontraditional biologic and social risk factors for stroke risk and outcomes. Enhanced understanding of these risk relationships is essential to any future efforts to develop more effective interventions to prevent strokes and reduce post-stroke morbidity and mortality.
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