. The purposes of this project are both to determine the risk of recurrent stroke in three urban ethnic groups, African-Americans, Latinos, and white non-Latinos and to determine the risk factors for recurrence in these groups. African-Americans and Latinos appear to be at greater risk, not only for initial stroke, but also for stroke recurrence. As the population ages and stroke mortality declines, the number of people at risk for recurrent stroke rises. At least 25% of hospital admissions for stroke are recurrent strokes. Recurrent stroke is therefore a large and growing public health concern. Since patients with stroke come to medical attention they are an easily identified group of people in need of preventive health measures. Identifying the major components of their recurrent stroke risk will provide a focus for these measures. To identify recurrent risk factors in the groups under study, a cohort of approximately 990 patients will be enrolled over a six year period and followed for up to four years. Putative risk factors for recurrent stroke will be identified at the time of index stroke. Control of major risk factors including hypertension, hyperglycemia, smoking, alcohol use and compliance with prescribed treatment will be monitored annually by in-person follow-up. Measures of end-organ involvement (viz., carotid artery wall thickness, left ventricular hypertrophy and compliance) will be obtained at two years post-stroke. Stroke-free survival rates will be estimated for each ethnic group and the independent determinants of recurrence will be identified with multivariate statistical techniques.
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