Stroke in American Indians and Alaska Natives: A Systematic Review

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We conducted a systematic review of published studies on stroke epidemiology in American Indians and Alaska Natives (AI/ANs). We used MeSH terms and strict inclusion criteria to search PubMed, identifying a relevant sample of 57 refereed publications. We report a consensus view in which prevalent stroke is more common, and estimates of cerebrovascular risk factors are higher, among AI/ANs than among other US populations. Like other minority groups, AI/ANs suffer stroke at younger ages than do non-Hispanic Whites. However, data on AI/AN stroke mortality are significantly compromised by racial misclassification and nonrepresentative sampling. Studies correcting for these problems have found that stroke mortality rates among AI/ANs are among the highest of all US racial and ethnic groups. As with Black and non-Hispanic White stroke mortality, AI/AN stroke mortality varies by geographic region, with the highest rates in Alaska and the Northwest and the lowest in the Southwest. Our results underscore the need for a concerted national effort to collect accurate cross-sectional and longitudinal data on stroke in AI/ANs.

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Raymond Harris, PhD, Lonnie A. Nelson, PhD, Clemma Muller, MS, and Dedra Buchwald, MDRaymond Harris, Clemma Muller, and Dedra Buchwald are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Lonnie A. Nelson is with the Department of Health Services, School of Public Health, University of Washington. “Stroke in American Indians and Alaska Natives: A Systematic Review”, American Journal of Public Health 105, no. 8 (August 1, 2015): pp. e16-e26.

PMID: 26066955