VARIATIONS IN STROKE INCIDENCE IN FOUR US COMMUNITIES: THE CARDIOVASCULAR HEALTH STUDY (CHS)

摘要: BACKGROUND: Although stroke rates are much higher in old age, recent data on geographic variation incidence older American populations were rare. Moreover, and mortality remain unexplained United States.OBJECTIVES: To compare risk factors their control four US communitiesMETHODS: Participants the Cardiovascular Health Study (CHS) who had no history of at baseline (n=5639) followed for 10 years development events. Site specific calculated. Possible across visits compared among CHS sites. RESULTS: Age sex standardized total per 1000 person-years 9.6 (CI 7.7, 11.5) Allegheny, 19.2 15.6, 22.8) Forsyth, 20.7 16.9, 24.5) Sacramento, 19.8 16.1, 23.5) Washington Counties. Allegheny County lowest 4 sites, factor distributions similar. After adjustment hypertension, diabetes, education, BMI, LDL cholesterol previous coronary heart disease, transient ischemic attack (TIA), atrial fibrillation (AF), there was modest reduction excess hazard other 3 sites to (HR=1.52, CI 1.17, 1.98 1.74 1.42, 2.14). between year 9, lipids, smoking, AF, TIA similar White matter grade (WMG) or more brain MRI less common than (25.8%and 36.3% respectively, p< 0.001) accounted 25% (HR=1.65, 1.20-2.26 1.87 1.36-2.55) CONCLUSION: Site-differences subsequent only partially explain site-differences incidence. PUBLIC HEALTH SIGNIFICANCE: may be a marker integrated exposure its progression could used as efficacy different prevention strategies community level.