Abstract Body: Introduction:
The Cameron County Hispanic Cohort (CCHC) represents a random sample of the Hispanic community residing in Cameron County, Texas. Participants were invited, regardless of their medical history, to participate every five years and went through extensive interviews and laboratory workout. This is the first report on the incidence of stroke in this cohort and provides a comprehensive examination for the associations between strokes and several cardiometabolic indicators.
Methods:
We conducted a case-cohort analysis to measure the associations between incident stroke and several cardiometabolic risk factors in the CCHC. Strokes were self-reported and we exclude subjects who reported strokes at their first visit as well as those who did not report on their stroke status. Chi square and Student t-test were used to test for univariate associations of several cardiometabolic indicators with incident strokes. We ran logistic regression models to estimate the associations of several cardiometabolic indicators with incident strokes after adjusting for age, diabetes, and hypertension. We used multiple imputation to estimate missing values for variables with more than 25% missingness. All analyses were conducted in R software (version 4.4.2)
Results:
The cumulative incidence for strokes was 0.02 (87 out of 4692 subjects). Those who presented with incident strokes were older (mean(sd): 61.4 (13.9) vs. 45.3 (15.9)), more likely to be diabetic (44 (50.6%) vs. 759 (16.5%)), and hypertensive (58 (66.7%) vs. 1194 (25.9%)), have higher inflammatory profile (e.g., C-Reactive Protein) (11.0 (26.3)vs. 7.92 (14.8)), thicker carotid intima (0.796 (0.250) vs. 0.681 (0.179)), lower left ventricular ejection fraction (60.8 (8.69) vs. 63.9 (4.89)), and higher left ventricular mass (159 (45.7) vs. 141 (36.9)) when compared to those without strokes at baseline. Adjusted logistic regression models comparing those with strokes to those without strokes at baseline showed that Low Density Lipoprotein (OR: 0.99, 95%CI: 0.98 - 0.99) and metabolic syndrome (OR: 0.53, 95%CI: 0.33-0.84) to be significantly associated (p <0.05) with incident stroke.
Conclusion:
This is the first analysis for incident strokes in this population which consists mostly (about 82%) of young (<65-year-old) Mexican Americans. Our longitudinal study design provided robust results; however, the small sample size may have limited our ability to detect important signals in our multivariate logistic models.