Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study

Dong-Seon Kang; Pil-Sung Yang; Daehoon Kim; Eunsun Jang; Hee Tae Yu; Tae-Hoon Kim; Jung-Hoon Sung; Hui-Nam Pak; Moon-Hyoung Lee; Gregory Y. H. Lip; Boyoung Joung

doi:10.1055/a-2278-8769

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2024; 124(09): 883-892
DOI: 10.1055/a-2278-8769

Stroke, Systemic or Venous Thromboembolism

Racial Differences in Ischemic and Hemorrhagic Stroke: An Ecological Epidemiological Study

Authors

Dong-Seon Kang‡^*

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Pil-Sung Yang‡^*

²Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
Daehoon Kim

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Eunsun Jang

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Hee Tae Yu

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Tae-Hoon Kim

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Jung-Hoon Sung

²Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
Hui-Nam Pak

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Moon-Hyoung Lee

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Gregory Y. H. Lip ^**

³Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom

⁴Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Boyoung Joung^**

¹Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

Abstract

Background This study aimed to evaluate racial differences in the incidence of stroke by conducting an ecological epidemiological study using UK Biobank and Korean nationwide data.

Methods This study used individual data from the Korean National Health Insurance Service-Health Screening and UK Biobank, which included participants who underwent health examinations between 2006 and 2010. We included 112,750 East Asians (50.7% men, mean age: 52.6 years) and 210,995 Caucasians (44.7% men, mean age: 55.0 years) who were not diagnosed with atrial fibrillation, cardiovascular diseases, chronic kidney disease, chronic obstructive pulmonary disease, or cancer. The primary outcome was defined as a composite of ischemic and hemorrhagic stroke.

Results East Asians tended to have a lower body mass index (23.7 vs. 26.4 kg/m², p < 0.001) and a higher proportion of participants who did not engage in moderate-to-vigorous physical activity (49.6% vs. 10.7%, p < 0.001) than Caucasians. During the follow-up, East Asians had higher 5-year incidence rates (presented as per 1,000 person-years) for primary outcome (1.73 vs. 0.50; IR ratio [IRR]: 3.48, 95% confidence interval [CI]: 3.13–3.88), ischemic stroke (1.23 vs. 0.33; IRR: 3.70, 95% CI: 3.25–4.21), hemorrhagic stroke (0.56 vs. 0.18; IRR: 3.20, 95% CI: 2.67–3.84), and atrial fibrillation-related stroke (0.19 vs. 0.09; IRR: 2.04, 95% CI: 1.55–2.68).

Conclusion Based on this ecological epidemiological study, racial differences in stroke incidence were robust to a variety of statistical analyses, regardless of the subtype. This suggests the need for region-specific approaches to stroke prevention.

Keywords

racial differences - atrial fibrillation - stroke

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Referenzen

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