TY - JOUR
T1 - Trends Over Time in Stroke Incidence by Race in the Greater Cincinnati Northern Kentucky Stroke Study
AU - Madsen, Tracy E.
AU - Ding, Lili
AU - Khoury, Jane C.
AU - Haverbusch, Mary
AU - Woo, Daniel
AU - Ferioli, Simona
AU - De Los Rios La Rosa, Felipe
AU - Martini, Sharyl R.
AU - Adeoye, Opeolu
AU - Khatri, Pooja
AU - Flaherty, Matthew L.
AU - Mackey, Jason
AU - Mistry, Eva A.
AU - Demel, Stacie
AU - Coleman, Elisheva
AU - Jasne, Adam
AU - Slavin, Sabreena
AU - Walsh, Kyle B.
AU - Star, Michael
AU - Broderick, Joseph P.
AU - Kissela, Brett
AU - Kleindorfer, Dawn O.
N1 - Publisher Copyright:
Copyright © 2024 American Academy of Neurology.
PY - 2024/1/10
Y1 - 2024/1/10
N2 - Background and Objectives Understanding the current status of and temporal trends of stroke epidemiology by age, race, and stroke subtype is critical to evaluate past prevention efforts and to plan future interventions to eliminate existing inequities. We investigated trends in stroke incidence and case fatality over a 22-year time period. Methods In this population-based stroke surveillance study, all cases of stroke in acute care hospitals within a 5-county population of southern Ohio/northern Kentucky in adults aged ≥20 years were ascertained during a full year every 5 years from 1993 to 2015. Temporal trends in stroke epidemiology were evaluated by age, race (Black or White), and subtype (ischemic stroke [IS], intracranial hemorrhage [ICH], or subarachnoid hemorrhage [SAH]). Stroke incidence rates per 100,000 individuals from 1993 to 2015 were calculated using US Census data and agestandardized, race-standardized, and sex-standardized as appropriate. Thirty-day case fatality rates were also reported. Results Incidence rates for stroke of any type and IS decreased in the combined population and among White individuals (any type, per 100,000, 215 [95% CI 204.226] in 1993/4 to 170 [95% CI 161.179] in 2015, p = 0.015). Among Black individuals, incidence rates for stroke of any type decreased over the study period (per 100,000, 349 [95% CI 311.386] in 1993/4 to 311 [95% CI 282.340] in 2015, p = 0.015). Incidence of ICH was stable over time in the combined population and in race-specific subgroups, and SAH decreased in the combined groups and in White adults. Incidence rates among Black adults were higher than those of White adults in all time periods, and Black:White risk ratios were highest in adults in young and middle age groups. Case fatality rates were similar by race and by time period with the exception of SAH in which 30-day case fatality rates decreased in the combined population and White adults over time. Discussion Stroke incidence is decreasing over time in both Black and White adults, an encouraging trend in the burden of cerebrovascular disease in the US population. Unfortunately, however, Black: White disparities have not decreased over a 22-year period, especially among younger and middle-aged adults, suggesting the need for more effective interventions to eliminate inequities by race.
AB - Background and Objectives Understanding the current status of and temporal trends of stroke epidemiology by age, race, and stroke subtype is critical to evaluate past prevention efforts and to plan future interventions to eliminate existing inequities. We investigated trends in stroke incidence and case fatality over a 22-year time period. Methods In this population-based stroke surveillance study, all cases of stroke in acute care hospitals within a 5-county population of southern Ohio/northern Kentucky in adults aged ≥20 years were ascertained during a full year every 5 years from 1993 to 2015. Temporal trends in stroke epidemiology were evaluated by age, race (Black or White), and subtype (ischemic stroke [IS], intracranial hemorrhage [ICH], or subarachnoid hemorrhage [SAH]). Stroke incidence rates per 100,000 individuals from 1993 to 2015 were calculated using US Census data and agestandardized, race-standardized, and sex-standardized as appropriate. Thirty-day case fatality rates were also reported. Results Incidence rates for stroke of any type and IS decreased in the combined population and among White individuals (any type, per 100,000, 215 [95% CI 204.226] in 1993/4 to 170 [95% CI 161.179] in 2015, p = 0.015). Among Black individuals, incidence rates for stroke of any type decreased over the study period (per 100,000, 349 [95% CI 311.386] in 1993/4 to 311 [95% CI 282.340] in 2015, p = 0.015). Incidence of ICH was stable over time in the combined population and in race-specific subgroups, and SAH decreased in the combined groups and in White adults. Incidence rates among Black adults were higher than those of White adults in all time periods, and Black:White risk ratios were highest in adults in young and middle age groups. Case fatality rates were similar by race and by time period with the exception of SAH in which 30-day case fatality rates decreased in the combined population and White adults over time. Discussion Stroke incidence is decreasing over time in both Black and White adults, an encouraging trend in the burden of cerebrovascular disease in the US population. Unfortunately, however, Black: White disparities have not decreased over a 22-year period, especially among younger and middle-aged adults, suggesting the need for more effective interventions to eliminate inequities by race.
UR - https://www.scopus.com/pages/publications/85189253245
U2 - 10.1212/WNL.0000000000208077
DO - 10.1212/WNL.0000000000208077
M3 - Article
C2 - 38546235
AN - SCOPUS:85189253245
SN - 0028-3878
VL - 102
JO - Neurology
JF - Neurology
IS - 3
M1 - e208077
ER -