South Asian strokes: lessons from the St Mary's stroke database

Abstract

Background: South Asians comprise the largest ethnic minority population in the UK. This subgroup is known to have an elevated risk of stroke. However, there is limited data on patterns of cerebrovascular disease and associated risk factors in this population.

Aim: The aim of this study was to analyse differences in stroke subtype and risk factor profile between South Asian and White stroke patients admitted to a central London teaching hospital.

Design: Prospective database of all admissions to the St Mary's Hospital stroke unit.

Methods: We examined ethnicity, stroke subtype and risk factor profile of consecutive patients admitted to the stroke unit between 8 October 2003 and 14 February 2007.

Results: A total of 811 patients were identified of whom 736 had strokes. Four hundred and ninety-six (67%) occurred in the White subgroup, and 72 (10%) in the Asian subgroup. The South Asian subgroup was significantly younger (65 vs. 73 years in the White subgroup; P < 0.001). They had higher rates of hypertension (age adjusted frequency 87% vs. 64%; P < 0.0001), diabetes (54% vs. 15%; P < 0.0001), and hyperlipidaemia (70% vs. 45%; P = 0.001). There were lower rates of smoking (15% vs. 33%; P < 0.0001).There was a trend towards more lacunar infarcts and less total anterior circulation infarcts in South Asians, although after age adjustment this was not significant at the 5% level.

Conclusion: The South Asian subgroup has shown important differences in risk factor profile compared with the White population. The higher frequency of hypertension, diabetes and hyperlipidaemia seen in this subgroup are an important consideration in designing secondary prevention programmes tailored specifically to this community.