STROKE INCIDENCE AND PROGNOSIS IN A MIXED ETHNIC REGION

Stroke is a leading cause of death and one of the major sources of disability in the United States. Yet, there are still gaps in our understanding of the risk factors, subtypes and outcomes after stroke, particularly in African and Hispanic Americans. The underlying goal of the Northern Manhattan Stroke Study is to provide vital information to help develop stroke prevention strategies in such populations. This epidemiological study is designed to determine the effect of stroke risk factors and stroke prognosis in white non-Hispanic, black non-Hispanic and Hispanic men and women residents of Northern Manhattan. The study has 3 components: an incidence study, a case-control study and a prospective cohort study. The incidence study which included all first strokes from Northern Manhattan was completed in 1997. Stroke risk factors have been identified through the case-control method, however due to continued grant support this study has evolved from a case-control study to a prospective cohort study. This thrust is to expand the enrollment of stroke-free subjects over age 54 and follow them through telephone and in-person assessments for stroke, MI and death. The stroke-free sample would consist of 1400 controls enrolled as part of the parent study from 1993-97 and a new sample of 1900 stroke-free subjects enrolled as part of the new grant from 1998-2000. Data is collected through in-person interview of the subject or surrogate on demographics, medical, dental and neurological history, stroke risk factors, neurological examinations, functional status, quality of life, blood studies and results of diagnostic studies (electrocardiogram, vascular ultrasound, cardiac ultrasound, endothelial reactivity.