Two strokes and
you’re out? Latinos especially at risk
Newswise — Having a stroke is bad
enough. But having another one after surviving the first one is
especially bad, more than doubling a person’s risk of dying in the
next two years, a new study finds.
The risk of a second
stroke is especially high among members of the largest and
fastest-growing subgroup of Latinos in the United States:
Mexican-Americans. The new study finds that they are more
likely than their non-Latino white neighbors to suffer
another stroke in the first two years after living through
one.
The study, published in
the Annals of Neurology by a team from the University of
Michigan Stroke Program in conjunction with colleagues in
Texas, highlights the importance of what doctors call
‘secondary prevention.’
In other words, those who live
through a stroke should get special attention from their physicians
and other health professionals to reduce their risk of having
another one. And, because of their extra risk of suffering another
stroke, those efforts should be especially stepped up in
Mexican-Americans, the researchers say.
“This finding completes a picture
that has been taking shape through research on ethnic differences in
stroke,” says lead author Lynda Lisabeth, Ph.D. “We know that
Mexican-Americans have a higher overall risk of stroke, tend to have
strokes starting at younger ages, and generally have a better chance
of surviving their first stroke, compared with non-Hispanic whites.
Now, by finding this higher rate of recurrence, we have a better
idea of the overall burden of stroke in this population.”
Lisabeth, an assistant professor
of epidemiology at the U-M School of Public Health, performed the
study with her colleagues from the U-M Medical School, who have led
a study of stroke in the southeastern coastal area of Texas near the
city of Corpus Christi for several years. That area was chosen
because of its large population of Mexican-Americans; they make up
just over half the population.
Because of the predominance of
Mexican-Americans and non-Latino whites in the study population,
results for other Latino subgroups and African-Americans are not
available.
The study followed 1,345 people
who had their first strokes between 2000 and 2004 — 53 percent of
whom were Mexican-Americans — and determined the frequency of
recurrence through the end of 2004 and recorded details about their
demographics, other health problems, and whether or not they had had
another stroke.
They then compared these recurrent
stroke patients with the other stroke survivors who had not had a
second stroke; in all the study includes data from 124 recurrent
stroke patients and 417 deaths among 1,311 stroke survivors for whom
complete data were available.
Mexican-American ethnicity was a
strong factor in a person’s risk of a second stroke. The risk of
recurrent stroke at two years among the first-time stroke survivors
was 11 percent.
When the researchers looked at the
risk of dying from any cause during the study period, the impact of
having a second stroke was dramatic. Stroke survivors who suffered a
second stroke were 2.67 times more likely to die than stroke
survivors who did not have a second stroke in the study period. The
increased risk from recurrent stroke was present for both ethnic
groups even after the researchers corrected for other health
factors, age and gender.
Now, Lisabeth says, she hopes
other researchers will attempt to confirm these findings in other
Latino subgroups and in other samples of Mexican Americans. And, it
will be important to find out what factors – including genetics,
cultural and lifestyle differences, and underlying health problems –
contribute to the ethnic differences.
In the meantime, she and her
colleagues suggest that people of any background who have survived a
stroke or “mini stroke” (also called a transient ischemic attack or
TIA) should talk with their doctors often about what steps to take
to reduce the risk of another stroke. Quitting smoking, keeping
cholesterol and blood pressure levels down, controlling blood sugar
for people with diabetes, and having a healthy diet and exercise
routine can all help.
The authors also call for better
awareness of stroke prevention methods and stroke symptoms among all
at-risk individuals, to help prevent a first stroke or speed the
recognition of a stroke when it occurs. Stroke symptoms include
sudden onset of weakness or numbness on one side of the body,
difficulty speaking or understanding, sudden clumsiness or
unexplained falls and suddent loss of vision in one of both eyes.
In addition to Lisabeth, the new
paper’s authors are Melinda Smith, MPH, Devin Brown, M.D., M.S.,
Lemuel Moye, M.D., Ph.D., Jan Risser, Ph.D., and Lewis Morgenstern,
M.D., of the U-M Medical School and the University of Texas Health
Science Center at Houston.
