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Thromb Haemost
DOI: 10.1055/a-2278-8769
Stroke, Systemic or Venous Thromboembolism

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

Dong-Seon Kang‡   *
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Pil-Sung Yang‡   *
2   Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
,
Daehoon Kim
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Eunsun Jang
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Hee Tae Yu
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Tae-Hoon Kim
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Jung-Hoon Sung
2   Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
,
Hui-Nam Pak
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Moon-Hyoung Lee
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Gregory Y. H. Lip    **
3   Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
4   Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
,
Boyoung Joung   **
1   Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
› Author Affiliations Funding This research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health and Welfare, Republic of Korea (HC19C0130).
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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

* These authors contributed equally to this work.


** These authors are Joint senior authors.


Supplementary Material



Publication History

Received: 10 December 2023

Accepted: 28 February 2024

Accepted Manuscript online:
29 February 2024

Article published online:
05 April 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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