Mexican-Americans more likely to suffer a recurrent stroke

Having a stroke is bad enough. But having another one after surviving the first is especially bad, as it more than doubles 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 study finds 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 U-M in conjunction with colleagues in Texas, highlights the importance of secondary prevention. Doctors say those who live through a stroke should get special attention from their physicians and other health professionals to reduce their risk of having a second. And, because of their extra risk, researchers say prevention efforts should be stepped up for Mexican-Americans.

"This finding completes a picture that has been taking shape through research on ethnic differences in stroke," says lead author Lynda Lisabeth, an assistant professor of epidemiology at the School of Public Health. "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 and colleagues from the Medical School led the study of stroke in the southeastern coastal area of Texas near Corpus Christi, an area where Mexican-Americans make up just over half the population.

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 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 those 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.

In addition to Lisabeth, the paper's authors are Melinda Smith, Dr. Devin Brown, Dr. Lemuel Moye, Jan Risser, and Dr. Lewis Morgenstern of the U-M Medical School and the University of Texas Health Science Center at Houston. The U-M Stroke Program, directed by Morgenstern, is part of the Cardiovascular Center.

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