STROKE INCIDENCE AMONG WHITE, BLACK, AND HISPANIC RESIDENTS OF AN URBAN-COMMUNITY - THE NORTHERN MANHATTAN STROKE STUDY

Stroke mortality is reported to be greater in blacks than in whites, b ut stroke incidence data for blacks and Hispanics are sparse. The aim of this study was to determine and compare stroke incidence rates amon g whites, blacks, and Hispanics living in the same urban community. A population-based incidence study was conducted to identify all cases o f first stroke occurring in northern Manhattan, New York City, between July 1, 1993, and June 30, 1996. The population of this area was appr oximately 210,000 at that time, based on 1990 US Census data. Surveill ance for hospitalized and nonhospitalized stroke consisted of daily sc reening of all admissions, discharges, and computed tomography logs at Columbia-Presbyterian Medical Center, the only hospital in the region , and review of discharge lists from outside hospitals, telephone surv eys of random households, and contacts with community physicians, Visi ting Nurses' Services, and community agencies. Stroke incidence increa sed with age and was greater in men than in women. The average annual age-adjusted stroke incidence rate at age greater than or equal to 20 years, per 100,000 population, was 223 for blacks, 196 for Hispanics, and 93 for whites. Blacks had a 2.4-fold and Hispanics a twofold incre ase in stroke incidence compared with whites. Cerebral infarct account ed for 77 percent of all strokes, intracerebral hemorrhage for 17 perc ent, and subarachnoid hemorrhage for 6 percent. These data from the No rthern Manhattan Stroke Study suggest that part of the reported excess stroke mortality among blacks in the United States may be a reflectio n of racial/ethnic differences in stroke incidence.