The epidemiology of stroke in Native Americans.

BACKGROUND AND PURPOSE: Because of the paucity of published information, this report seeks to better characterize the pattern of stroke occurrence and risk factors among Native Americans in the United States. METHODS: Data from the US Vital Statistics System and two National Health and Nutrition Examination Surveys were analyzed. RESULTS: Stroke was a leading cause of death among US Native Americans in 1990. In persons aged 45 and over, stroke was the cause of 6% of deaths in Native Americans and 7% of deaths in whites. The percentage of stroke deaths due to hemorrhagic stroke was higher in Native Americans than whites. In 1988 through 1990, stroke death rates were similar in Native Americans and whites under age 65 but lower in Native Americans at ages 65 years and over. High prevalence of diabetes, smoking, and obesity may contribute to stroke mortality in Native Americans. CONCLUSIONS: Targeted research, innovative analyses of existing data, and use of ongoing surveys and the Census should be considered in the study of the epidemiology of stroke, other leading causes of death, and risk factors in Native Americans. Continued hypertension detection and treatment efforts are needed for Native Americans as for other groups. Smoking cessation and prevention should receive high priority in Native American populations.