The goal of this project is to better understand the etiology of stroke in all segments of our society and identify what differences exist between these segments so that programs for stroke prevention may be designed for minority populations addressing potent, modifiable risk factors for stroke in these communities. The primary hypothesis to be tested is: The increased risk of stroke in the African-American and Hispanic populations is due to an increased prevalence of recognized factors for stroke as determined primarily from studies of whites. Based on observations of stroke admissions during the past two years, it is anticipated that 750 incident stroke cases can be recruited from admissions to these facilities in 3.25 years. Of these, 150 will be Hispanic, 225 will be African-American and 375 will be white. Each Hispanic and African- American case will be matched with two neighborhood controls of the same ethnicity, while whites will be matched on a one-to-one basis. Controls will be recruited with the aid of community organizations with whom Mount Sinai has an ongoing relationship. Information regarding stroke risk factors, including hypertension, diabetes, smoking, serum lipids, carotid and cardiac disease, will be obtained by interview, blood sampling, EKG and ultrasound evaluations. From these data, multiple logistic regression models will be developed to estimate the relative and attributable risk associated with these factors for each of these groups. It will then be possible to determine if there are clinically important differences in risk factor configurations among these groups.
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