Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors
BACKGROUND AND PURPOSE—The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European A...
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| creator | Owolabi, Mayowa Sarfo, Fred Howard, Virginia J Irvin, Marguerite R Gebregziabher, Mulugeta Akinyemi, Rufus Bennett, Aleena Armstrong, Kevin Tiwari, Hemant K Akpalu, Albert Wahab, Kolawole W Owolabi, Lukman Fawale, Bimbo Komolafe, Morenikeji Obiako, Reginald Adebayo, Philip Manly, Jennifer M Ogbole, Godwin Melikam, Ezinne Laryea, Ruth Saulson, Raelle Jenkins, Carolyn Arnett, Donna K Lackland, Daniel T Ovbiagele, Bruce Howard, George |
| description | BACKGROUND AND PURPOSE—The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA).
METHODS—SIREN (Stroke Investigative Research and Educational Network) is a large multinational case–control study in West Africa—the ancestral home of 71% AA—whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies.
RESULTS—There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3 years, respectively (P |
| doi_str_mv | 10.1161/STROKEAHA.116.015937 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5404953</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1885952715</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3607-61df8cb107b53e08491a07226307d386e0152ba58e46f5b25c29c643d5516fac3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0EokPhHyCUJYum-B2bBVJUTR-iUqW2rC3HuZkx9cTBTqj678kwnVHZsLLv9XeO7XsQ-kjwKSGSfLm7v735vqwv6215ionQrHqFFkRQXnJJ1Wu0wJjpknKtj9C7nH9ijClT4i06ooopLQlZoPFuTPEBCt8XV33rV9DHKRd1l7yzfT7Z74p6A_uW7dtiOaU4wMv-11k_QhqCfSpiV9xa5234y15AXCU7rL0rzq0bY8rv0ZvOhgwfntdj9ON8eX92WV7fXFyd1delYxJXpSRtp1xDcNUIBlhxTSyuKJUMVy1TEuZP08YKBVx2oqHCUe0kZ60QRHbWsWP0bec7TM0GWgf9mGwwQ_Ibm55MtN78e9L7tVnF30ZwzLVgs8HnZ4MUf02QR7Px2UEItod5ToYoJbSgFREzyneoSzHnBN3hGoLNNjBzCGxbml1gs-zTyyceRPuEZkDtgMcY5vnmhzA9QjJrsGFc_9_7Dzc8pP4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1885952715</pqid></control><display><type>article</type><title>Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Journals@Ovid Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Owolabi, Mayowa ; Sarfo, Fred ; Howard, Virginia J ; Irvin, Marguerite R ; Gebregziabher, Mulugeta ; Akinyemi, Rufus ; Bennett, Aleena ; Armstrong, Kevin ; Tiwari, Hemant K ; Akpalu, Albert ; Wahab, Kolawole W ; Owolabi, Lukman ; Fawale, Bimbo ; Komolafe, Morenikeji ; Obiako, Reginald ; Adebayo, Philip ; Manly, Jennifer M ; Ogbole, Godwin ; Melikam, Ezinne ; Laryea, Ruth ; Saulson, Raelle ; Jenkins, Carolyn ; Arnett, Donna K ; Lackland, Daniel T ; Ovbiagele, Bruce ; Howard, George</creator><creatorcontrib>Owolabi, Mayowa ; Sarfo, Fred ; Howard, Virginia J ; Irvin, Marguerite R ; Gebregziabher, Mulugeta ; Akinyemi, Rufus ; Bennett, Aleena ; Armstrong, Kevin ; Tiwari, Hemant K ; Akpalu, Albert ; Wahab, Kolawole W ; Owolabi, Lukman ; Fawale, Bimbo ; Komolafe, Morenikeji ; Obiako, Reginald ; Adebayo, Philip ; Manly, Jennifer M ; Ogbole, Godwin ; Melikam, Ezinne ; Laryea, Ruth ; Saulson, Raelle ; Jenkins, Carolyn ; Arnett, Donna K ; Lackland, Daniel T ; Ovbiagele, Bruce ; Howard, George ; SIREN-REGARDS Collaboration (Stroke Investigative Research and Educational Network–Reasons for Geographic and Racial Differences in Stroke)</creatorcontrib><description>BACKGROUND AND PURPOSE—The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA).
METHODS—SIREN (Stroke Investigative Research and Educational Network) is a large multinational case–control study in West Africa—the ancestral home of 71% AA—whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies.
RESULTS—There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3 years, respectively (P<0.0001). Hemorrhagic stroke was more frequent among IA (27%) compared with AA (8%) and EA (5.4%; P<0.001). Lacunar strokes were more prevalent in IA (47.1%), followed by AA (35.1%) and then EA (21.0%; P<0.0001). The frequency of hypertension in decreasing order was IA (92.8%), followed by AA (82.5%) and then EA (64.2%; P<0.0001) and similarly for diabetes mellitus IA (38.3%), AA (36.8%), and EA (21.0%; P<0.0001). Premorbid sedentary lifestyle was similar in AA (37.7%) and EA (34.0%) but lower frequency in IA (8.0%).
CONCLUSIONS—Environmental risk factors such as sedentary lifestyle may contribute to the higher proportion of ischemic stroke in AA compared with IA, whereas racial factors may contribute to the higher proportion of hypertension and diabetes mellitus among stroke subjects of African ancestry.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.116.015937</identifier><identifier>PMID: 28389611</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Africa, Western - ethnology ; African Americans - ethnology ; African Continental Ancestry Group - ethnology ; Aged ; Brain Ischemia - ethnology ; Case-Control Studies ; Cerebral Hemorrhage - ethnology ; European Continental Ancestry Group - ethnology ; Female ; Humans ; Hypertension - ethnology ; Male ; Middle Aged ; Risk Factors ; Sedentary Lifestyle - ethnology ; Stroke - ethnology ; Stroke, Lacunar - ethnology ; United States - ethnology</subject><ispartof>Stroke (1970), 2017-05, Vol.48 (5), p.1169-1175</ispartof><rights>2017 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3607-61df8cb107b53e08491a07226307d386e0152ba58e46f5b25c29c643d5516fac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28389611$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Owolabi, Mayowa</creatorcontrib><creatorcontrib>Sarfo, Fred</creatorcontrib><creatorcontrib>Howard, Virginia J</creatorcontrib><creatorcontrib>Irvin, Marguerite R</creatorcontrib><creatorcontrib>Gebregziabher, Mulugeta</creatorcontrib><creatorcontrib>Akinyemi, Rufus</creatorcontrib><creatorcontrib>Bennett, Aleena</creatorcontrib><creatorcontrib>Armstrong, Kevin</creatorcontrib><creatorcontrib>Tiwari, Hemant K</creatorcontrib><creatorcontrib>Akpalu, Albert</creatorcontrib><creatorcontrib>Wahab, Kolawole W</creatorcontrib><creatorcontrib>Owolabi, Lukman</creatorcontrib><creatorcontrib>Fawale, Bimbo</creatorcontrib><creatorcontrib>Komolafe, Morenikeji</creatorcontrib><creatorcontrib>Obiako, Reginald</creatorcontrib><creatorcontrib>Adebayo, Philip</creatorcontrib><creatorcontrib>Manly, Jennifer M</creatorcontrib><creatorcontrib>Ogbole, Godwin</creatorcontrib><creatorcontrib>Melikam, Ezinne</creatorcontrib><creatorcontrib>Laryea, Ruth</creatorcontrib><creatorcontrib>Saulson, Raelle</creatorcontrib><creatorcontrib>Jenkins, Carolyn</creatorcontrib><creatorcontrib>Arnett, Donna K</creatorcontrib><creatorcontrib>Lackland, Daniel T</creatorcontrib><creatorcontrib>Ovbiagele, Bruce</creatorcontrib><creatorcontrib>Howard, George</creatorcontrib><creatorcontrib>SIREN-REGARDS Collaboration (Stroke Investigative Research and Educational Network–Reasons for Geographic and Racial Differences in Stroke)</creatorcontrib><title>Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>BACKGROUND AND PURPOSE—The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA).
METHODS—SIREN (Stroke Investigative Research and Educational Network) is a large multinational case–control study in West Africa—the ancestral home of 71% AA—whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies.
RESULTS—There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3 years, respectively (P<0.0001). Hemorrhagic stroke was more frequent among IA (27%) compared with AA (8%) and EA (5.4%; P<0.001). Lacunar strokes were more prevalent in IA (47.1%), followed by AA (35.1%) and then EA (21.0%; P<0.0001). The frequency of hypertension in decreasing order was IA (92.8%), followed by AA (82.5%) and then EA (64.2%; P<0.0001) and similarly for diabetes mellitus IA (38.3%), AA (36.8%), and EA (21.0%; P<0.0001). Premorbid sedentary lifestyle was similar in AA (37.7%) and EA (34.0%) but lower frequency in IA (8.0%).
CONCLUSIONS—Environmental risk factors such as sedentary lifestyle may contribute to the higher proportion of ischemic stroke in AA compared with IA, whereas racial factors may contribute to the higher proportion of hypertension and diabetes mellitus among stroke subjects of African ancestry.</description><subject>Africa, Western - ethnology</subject><subject>African Americans - ethnology</subject><subject>African Continental Ancestry Group - ethnology</subject><subject>Aged</subject><subject>Brain Ischemia - ethnology</subject><subject>Case-Control Studies</subject><subject>Cerebral Hemorrhage - ethnology</subject><subject>European Continental Ancestry Group - ethnology</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - ethnology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Risk Factors</subject><subject>Sedentary Lifestyle - ethnology</subject><subject>Stroke - ethnology</subject><subject>Stroke, Lacunar - ethnology</subject><subject>United States - ethnology</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv1DAUhS0EokPhHyCUJYum-B2bBVJUTR-iUqW2rC3HuZkx9cTBTqj678kwnVHZsLLv9XeO7XsQ-kjwKSGSfLm7v735vqwv6215ionQrHqFFkRQXnJJ1Wu0wJjpknKtj9C7nH9ijClT4i06ooopLQlZoPFuTPEBCt8XV33rV9DHKRd1l7yzfT7Z74p6A_uW7dtiOaU4wMv-11k_QhqCfSpiV9xa5234y15AXCU7rL0rzq0bY8rv0ZvOhgwfntdj9ON8eX92WV7fXFyd1delYxJXpSRtp1xDcNUIBlhxTSyuKJUMVy1TEuZP08YKBVx2oqHCUe0kZ60QRHbWsWP0bec7TM0GWgf9mGwwQ_Ibm55MtN78e9L7tVnF30ZwzLVgs8HnZ4MUf02QR7Px2UEItod5ToYoJbSgFREzyneoSzHnBN3hGoLNNjBzCGxbml1gs-zTyyceRPuEZkDtgMcY5vnmhzA9QjJrsGFc_9_7Dzc8pP4</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Owolabi, Mayowa</creator><creator>Sarfo, Fred</creator><creator>Howard, Virginia J</creator><creator>Irvin, Marguerite R</creator><creator>Gebregziabher, Mulugeta</creator><creator>Akinyemi, Rufus</creator><creator>Bennett, Aleena</creator><creator>Armstrong, Kevin</creator><creator>Tiwari, Hemant K</creator><creator>Akpalu, Albert</creator><creator>Wahab, Kolawole W</creator><creator>Owolabi, Lukman</creator><creator>Fawale, Bimbo</creator><creator>Komolafe, Morenikeji</creator><creator>Obiako, Reginald</creator><creator>Adebayo, Philip</creator><creator>Manly, Jennifer M</creator><creator>Ogbole, Godwin</creator><creator>Melikam, Ezinne</creator><creator>Laryea, Ruth</creator><creator>Saulson, Raelle</creator><creator>Jenkins, Carolyn</creator><creator>Arnett, Donna K</creator><creator>Lackland, Daniel T</creator><creator>Ovbiagele, Bruce</creator><creator>Howard, George</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170501</creationdate><title>Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors</title><author>Owolabi, Mayowa ; Sarfo, Fred ; Howard, Virginia J ; Irvin, Marguerite R ; Gebregziabher, Mulugeta ; Akinyemi, Rufus ; Bennett, Aleena ; Armstrong, Kevin ; Tiwari, Hemant K ; Akpalu, Albert ; Wahab, Kolawole W ; Owolabi, Lukman ; Fawale, Bimbo ; Komolafe, Morenikeji ; Obiako, Reginald ; Adebayo, Philip ; Manly, Jennifer M ; Ogbole, Godwin ; Melikam, Ezinne ; Laryea, Ruth ; Saulson, Raelle ; Jenkins, Carolyn ; Arnett, Donna K ; Lackland, Daniel T ; Ovbiagele, Bruce ; Howard, George</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3607-61df8cb107b53e08491a07226307d386e0152ba58e46f5b25c29c643d5516fac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Africa, Western - ethnology</topic><topic>African Americans - ethnology</topic><topic>African Continental Ancestry Group - ethnology</topic><topic>Aged</topic><topic>Brain Ischemia - ethnology</topic><topic>Case-Control Studies</topic><topic>Cerebral Hemorrhage - ethnology</topic><topic>European Continental Ancestry Group - ethnology</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - ethnology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Risk Factors</topic><topic>Sedentary Lifestyle - ethnology</topic><topic>Stroke - ethnology</topic><topic>Stroke, Lacunar - ethnology</topic><topic>United States - ethnology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Owolabi, Mayowa</creatorcontrib><creatorcontrib>Sarfo, Fred</creatorcontrib><creatorcontrib>Howard, Virginia J</creatorcontrib><creatorcontrib>Irvin, Marguerite R</creatorcontrib><creatorcontrib>Gebregziabher, Mulugeta</creatorcontrib><creatorcontrib>Akinyemi, Rufus</creatorcontrib><creatorcontrib>Bennett, Aleena</creatorcontrib><creatorcontrib>Armstrong, Kevin</creatorcontrib><creatorcontrib>Tiwari, Hemant K</creatorcontrib><creatorcontrib>Akpalu, Albert</creatorcontrib><creatorcontrib>Wahab, Kolawole W</creatorcontrib><creatorcontrib>Owolabi, Lukman</creatorcontrib><creatorcontrib>Fawale, Bimbo</creatorcontrib><creatorcontrib>Komolafe, Morenikeji</creatorcontrib><creatorcontrib>Obiako, Reginald</creatorcontrib><creatorcontrib>Adebayo, Philip</creatorcontrib><creatorcontrib>Manly, Jennifer M</creatorcontrib><creatorcontrib>Ogbole, Godwin</creatorcontrib><creatorcontrib>Melikam, Ezinne</creatorcontrib><creatorcontrib>Laryea, Ruth</creatorcontrib><creatorcontrib>Saulson, Raelle</creatorcontrib><creatorcontrib>Jenkins, Carolyn</creatorcontrib><creatorcontrib>Arnett, Donna K</creatorcontrib><creatorcontrib>Lackland, Daniel T</creatorcontrib><creatorcontrib>Ovbiagele, Bruce</creatorcontrib><creatorcontrib>Howard, George</creatorcontrib><creatorcontrib>SIREN-REGARDS Collaboration (Stroke Investigative Research and Educational Network–Reasons for Geographic and Racial Differences in Stroke)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Owolabi, Mayowa</au><au>Sarfo, Fred</au><au>Howard, Virginia J</au><au>Irvin, Marguerite R</au><au>Gebregziabher, Mulugeta</au><au>Akinyemi, Rufus</au><au>Bennett, Aleena</au><au>Armstrong, Kevin</au><au>Tiwari, Hemant K</au><au>Akpalu, Albert</au><au>Wahab, Kolawole W</au><au>Owolabi, Lukman</au><au>Fawale, Bimbo</au><au>Komolafe, Morenikeji</au><au>Obiako, Reginald</au><au>Adebayo, Philip</au><au>Manly, Jennifer M</au><au>Ogbole, Godwin</au><au>Melikam, Ezinne</au><au>Laryea, Ruth</au><au>Saulson, Raelle</au><au>Jenkins, Carolyn</au><au>Arnett, Donna K</au><au>Lackland, Daniel T</au><au>Ovbiagele, Bruce</au><au>Howard, George</au><aucorp>SIREN-REGARDS Collaboration (Stroke Investigative Research and Educational Network–Reasons for Geographic and Racial Differences in Stroke)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>48</volume><issue>5</issue><spage>1169</spage><epage>1175</epage><pages>1169-1175</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><abstract>BACKGROUND AND PURPOSE—The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA).
METHODS—SIREN (Stroke Investigative Research and Educational Network) is a large multinational case–control study in West Africa—the ancestral home of 71% AA—whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States. Using harmonized assessments and standard definitions, we compared data on stroke type and established risk factors for stroke in acute stroke cases aged ≥55 years in both studies.
RESULTS—There were 811 IA, 452 AA, and 665 EA stroke subjects, with mean age of 68.0±9.3, 73.0±8.3, and 76.0±8.3 years, respectively (P<0.0001). Hemorrhagic stroke was more frequent among IA (27%) compared with AA (8%) and EA (5.4%; P<0.001). Lacunar strokes were more prevalent in IA (47.1%), followed by AA (35.1%) and then EA (21.0%; P<0.0001). The frequency of hypertension in decreasing order was IA (92.8%), followed by AA (82.5%) and then EA (64.2%; P<0.0001) and similarly for diabetes mellitus IA (38.3%), AA (36.8%), and EA (21.0%; P<0.0001). Premorbid sedentary lifestyle was similar in AA (37.7%) and EA (34.0%) but lower frequency in IA (8.0%).
CONCLUSIONS—Environmental risk factors such as sedentary lifestyle may contribute to the higher proportion of ischemic stroke in AA compared with IA, whereas racial factors may contribute to the higher proportion of hypertension and diabetes mellitus among stroke subjects of African ancestry.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>28389611</pmid><doi>10.1161/STROKEAHA.116.015937</doi><tpages>7</tpages></addata></record> |
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| ispartof | Stroke (1970), 2017-05, Vol.48 (5), p.1169-1175 |
| issn | 0039-2499 1524-4628 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5404953 |
| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Africa, Western - ethnology African Americans - ethnology African Continental Ancestry Group - ethnology Aged Brain Ischemia - ethnology Case-Control Studies Cerebral Hemorrhage - ethnology European Continental Ancestry Group - ethnology Female Humans Hypertension - ethnology Male Middle Aged Risk Factors Sedentary Lifestyle - ethnology Stroke - ethnology Stroke, Lacunar - ethnology United States - ethnology |
| title | Stroke in Indigenous Africans, African Americans, and European Americans: Interplay of Racial and Geographic Factors |
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