Sleep apnea health disparities in Mexican American stroke patients

墨西哥裔美国中风患者的睡眠呼吸暂停健康差异

• 批准号: 8450206
• 负责人: DEVIN L BROWN
• 金额: $ 54.96万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-05-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8450206
• 关键词: Academic Medical Centers; Accounting; Acute; Admixture; Adult; Age; American; Build-it; Cardiopulmonary; Caring; Cause of Death; Cerebral hemisphere hemorrhage; Cognitive; County; Data; Data Collection; Devices; Disease; Education; Environmental Risk Factor; Epidemiology; European; Event; Frequencies; Future; Genes; Genetic; Genetic Determinism; Goals; Health; Health Professional; Health Services; Health Services Accessibility; High Prevalence; Hispanic Americans; Hispanics; Impairment; Inherited; Intervention; Interview; Investigation; Ischemic Stroke; Laboratories; Life Style; Link; Measures; Methods; Mexican Americans; Minority; Minority Groups; Neurologic; Obesity; Outcome; Parents; Patients; Population; Population Heterogeneity; Preparation; Prevalence; Provider; Publishing; Quality of life; Questionnaires; Recurrence; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Severities; Sleep; Sleep Apnea Syndromes; Smoking; Stroke; Subgroup; Symptoms; Testing; Texas; United States; acute stroke; cognitive function; cost; cost effective; disability; early onset; ethnic difference; experience; functional outcomes; genetic risk factor; health disparity; high risk; improved; innovation; lifestyle factors; mortality; novel; population based; post stroke; prevent; public health relevance; screening; social; surveillance study; therapy development

DESCRIPTION (provided by applicant): Stroke is the leading cause of adult disability in the US and a leading cause of death. Mexican Americans (MA), the largest subgroup of Hispanic Americans, have a substantially higher stroke risk than European Americans, especially at younger ages where the risk is more than double. Given the greater risk and earlier onset, the impact of stroke is disproportionately experienced by MAs. Reasons for increased stroke risk in MAs are poorly understood. More than half of ischemic stroke patients have sleep apnea, a very common and important risk factor for stroke and potentially a risk factor for poor stroke outcome. No published studies have established the prevalence of sleep apnea in MAs to discern sleep apnea's contribution to excess stroke burden in this population. Small studies conducted in academic medical centers have suggested that stroke patients with sleep apnea have particularly poor stroke outcomes, but population-based studies in diverse populations are lacking. The current application seeks to investigate health disparities related to sleep apnea in stroke patients in order to understand the marked ethnic differences in stroke. This research will inform the development of interventions to prevent or treat sleep apnea in MAs, which will reduce the ethnic stroke disparity. The parent study for this project, the Brain Attack Surveillance in Corpus Christi (BASIC) project, is an ongoing population-based stroke surveillance study that identifies stroke cases in Nueces County, Texas. This study has made many important discoveries about stroke in Hispanics. BASIC will continue to identify all strokes in Nueces County until mid year 3 of the current application and will provide detailed 90-day stroke outcome data until mid year 2. The current application will extend BASIC data collection through year 5 month 3 and will add: (1) sleep apnea screening in the acute stroke period that differentiates obstructive from central events, (2) sleep apnea screening for intracerebral hemorrhage cases, (3) access to care measures for sleep apnea, and (4) genetic admixture analysis to investigate how genetics may relate to ethnic disparities in sleep apnea. The application seeks, in a cost-containing fashion, to understand and remedy the influence of a very frequent risk factor, sleep apnea, on a common, devastating disease, stroke, in the largest and fastest growing US minority population.

描述（由申请人提供）：中风是美国成人残疾的主要原因，也是死亡的主要原因。墨西哥裔美国人 (MA) 是西班牙裔美国人中最大的亚群，其中风风险比欧洲裔美国人高得多，尤其是在年轻时，中风风险是欧洲裔美国人的两倍多。鉴于中风的风险更大且发病更早，MA 所经历的中风影响尤为严重。 MA 中风风险增加的原因尚不清楚。超过一半的缺血性中风患者患有睡眠呼吸暂停，这是中风非常常见且重要的危险因素，也是中风预后不良的潜在危险因素。尚无已发表的研究确定马萨诸塞州睡眠呼吸暂停的患病率，以了解睡眠呼吸暂停对这一人群中过度卒中负担的影响。在学术医疗中心进行的小型研究表明，患有睡眠呼吸暂停的中风患者的中风结果特别差，但缺乏针对不同人群的基于人群的研究。当前的申请旨在调查中风患者与睡眠呼吸暂停相关的健康差异，以了解中风的显着种族差异。这项研究将为预防或治疗马萨诸塞州睡眠呼吸暂停的干预措施的制定提供信息，这将减少种族中风的差异。该项目的母研究是科珀斯克里斯蒂脑部攻击监测 (BASIC) 项目，是一项正在进行的基于人群的中风监测研究，旨在识别德克萨斯州纽埃西斯县的中风病例。这项研究在西班牙裔中风方面取得了许多重要发现。 BASIC 将继续识别纽埃西斯县的所有中风，直至当前申请的第 3 年中，并将提供详细的 90 天中风结果数据，直至第 2 年中。当前的申请将把 BASIC 数据收集延长至第 5 年第 3 个月，并将添加： (1) 急性中风期的睡眠呼吸暂停筛查，区分阻塞性事件和中枢性事件，(2) 脑出血病例的睡眠呼吸暂停筛查，(3) 获得睡眠护理措施呼吸暂停，(4) 遗传混合分析，以研究遗传学与睡眠呼吸暂停的种族差异之间的关系。该应用程序旨在以控制成本的方式了解和纠正一种非常常见的危险因素——睡眠呼吸暂停——对美国数量最多、增长最快的少数族裔人口中一种常见的毁灭性疾病——中风的影响。