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

Abstract

BackgroundThis study aimed to evaluate racial differences in the incidence of strokeby conducting an ecological epidemiological study using UK Biobank and Koreannationwide data. MethodsThis study used individual data from the Korean National Health InsuranceService-Health Screening and UK Biobank, which included participants who underwenthealth 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: 55.0years) who were not diagnosed with atrialfibrillation, cardiovascular diseases, chronickidney disease, chronic obstructive pulmonary disease, or cancer. The primaryoutcome was defined as a composite of ischemic and hemorrhagic stroke. ResultsEast Asians tended to have a lower body mass index (23.7 vs. 26.4kg/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 thefollow-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 atrialfibrilla-tion-related stroke (0.19 vs. 0.09; IRR: 2.04, 95% CI: 1.55-2.68). ConclusionBased on this ecological epidemiological study, racial differences instroke incidence were robust to a variety of statistical analyses, regardless of thesubtype. This suggests the need for region-specific approaches to stroke prevention