Race and sex differences in the distribution of cerebral atherosclerosis

R. J. Wityk, D. Lehman, M. Klag, J. Coresh, H. Ahn, B. Litt

Research output: Contribution to journalArticle

Abstract

Background and Purpose: The purpose of this study was to assess the influence of race, sex, and other risk factors on the location of atherosclerotic occlusive lesions in cerebral vessels. Previous angiographic studies of patients with stroke or transient ischemic attack (TIA) suggest that extracranial atherosclerosis is more common in whites and intracranial disease is more common in blacks. Noninvasive techniques such as duplex ultrasound, transcranial Doppler (TCD), and magnetic resonance angiography (MRA) allow vascular assessment of a more representative proportion of patients than does conventional angiography alone. Methods: Consecutive patients evaluated at a community hospital for stroke or TIA over a 2-year period were reviewed. Lesions were defined as a 50% or greater atherosclerotic stenosis by angiography, duplex ultrasound, or TCD, or a moderate stenosis by MRA. Results: Whites were more likely than blacks to have extracranial carotid artery lesions (33% versus 15%, P = .001), but the proportion of patients with intracranial lesions was similar (24% versus 22%). Men were more likely to have intracranial lesions than women (29% versus 14%, P = .03). When multivariate logistic regression analysis was used, white race was the only predictor for extracranial carotid artery lesions, and male sex was the only predictor for intracranial lesions. The cause of stroke/TIA was extracranial carotid artery disease in 8% and intracranial disease in 8% of all patients in the study. Conclusions: The distribution of cerebral atherosclerosis is influenced by race and sex but not by other vascular risk factors. In our patient population, intracranial disease is as common a cause of cerebral ischemia as extracranial carotid disease.

LanguageEnglish (US)
Pages1974-1980
Number of pages7
JournalStroke
Volume27
Issue number11
StatePublished - Nov 1996

Fingerprint

Intracranial Arteriosclerosis
Sex Characteristics
Transient Ischemic Attack
Magnetic Resonance Angiography
Stroke
Carotid Arteries
Angiography
Pathologic Constriction
Patient Advocacy
Doppler Ultrasonography
Carotid Artery Diseases
Community Hospital
Brain Ischemia
Blood Vessels
Atherosclerosis
Logistic Models
Regression Analysis
Population

Keywords

  • atherosclerosis
  • carotid arteries
  • cerebral arteries
  • racial differences

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Race and sex differences in the distribution of cerebral atherosclerosis. / Wityk, R. J.; Lehman, D.; Klag, M.; Coresh, J.; Ahn, H.; Litt, B.

In: Stroke, Vol. 27, No. 11, 11.1996, p. 1974-1980.

Research output: Contribution to journalArticle

Wityk, RJ, Lehman, D, Klag, M, Coresh, J, Ahn, H & Litt, B 1996, 'Race and sex differences in the distribution of cerebral atherosclerosis' Stroke, vol 27, no. 11, pp. 1974-1980.
Wityk, R. J. ; Lehman, D. ; Klag, M. ; Coresh, J. ; Ahn, H. ; Litt, B./ Race and sex differences in the distribution of cerebral atherosclerosis. In: Stroke. 1996 ; Vol. 27, No. 11. pp. 1974-1980
@article{dac0f45d3f5846de817606d1427885f2,
title = "Race and sex differences in the distribution of cerebral atherosclerosis",
abstract = "Background and Purpose: The purpose of this study was to assess the influence of race, sex, and other risk factors on the location of atherosclerotic occlusive lesions in cerebral vessels. Previous angiographic studies of patients with stroke or transient ischemic attack (TIA) suggest that extracranial atherosclerosis is more common in whites and intracranial disease is more common in blacks. Noninvasive techniques such as duplex ultrasound, transcranial Doppler (TCD), and magnetic resonance angiography (MRA) allow vascular assessment of a more representative proportion of patients than does conventional angiography alone. Methods: Consecutive patients evaluated at a community hospital for stroke or TIA over a 2-year period were reviewed. Lesions were defined as a 50{\%} or greater atherosclerotic stenosis by angiography, duplex ultrasound, or TCD, or a moderate stenosis by MRA. Results: Whites were more likely than blacks to have extracranial carotid artery lesions (33{\%} versus 15{\%}, P = .001), but the proportion of patients with intracranial lesions was similar (24{\%} versus 22{\%}). Men were more likely to have intracranial lesions than women (29{\%} versus 14{\%}, P = .03). When multivariate logistic regression analysis was used, white race was the only predictor for extracranial carotid artery lesions, and male sex was the only predictor for intracranial lesions. The cause of stroke/TIA was extracranial carotid artery disease in 8{\%} and intracranial disease in 8{\%} of all patients in the study. Conclusions: The distribution of cerebral atherosclerosis is influenced by race and sex but not by other vascular risk factors. In our patient population, intracranial disease is as common a cause of cerebral ischemia as extracranial carotid disease.",
keywords = "atherosclerosis, carotid arteries, cerebral arteries, racial differences",
author = "Wityk, {R. J.} and D. Lehman and M. Klag and J. Coresh and H. Ahn and B. Litt",
year = "1996",
month = "11",
language = "English (US)",
volume = "27",
pages = "1974--1980",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Race and sex differences in the distribution of cerebral atherosclerosis

AU - Wityk,R. J.

AU - Lehman,D.

AU - Klag,M.

AU - Coresh,J.

AU - Ahn,H.

AU - Litt,B.

PY - 1996/11

Y1 - 1996/11

N2 - Background and Purpose: The purpose of this study was to assess the influence of race, sex, and other risk factors on the location of atherosclerotic occlusive lesions in cerebral vessels. Previous angiographic studies of patients with stroke or transient ischemic attack (TIA) suggest that extracranial atherosclerosis is more common in whites and intracranial disease is more common in blacks. Noninvasive techniques such as duplex ultrasound, transcranial Doppler (TCD), and magnetic resonance angiography (MRA) allow vascular assessment of a more representative proportion of patients than does conventional angiography alone. Methods: Consecutive patients evaluated at a community hospital for stroke or TIA over a 2-year period were reviewed. Lesions were defined as a 50% or greater atherosclerotic stenosis by angiography, duplex ultrasound, or TCD, or a moderate stenosis by MRA. Results: Whites were more likely than blacks to have extracranial carotid artery lesions (33% versus 15%, P = .001), but the proportion of patients with intracranial lesions was similar (24% versus 22%). Men were more likely to have intracranial lesions than women (29% versus 14%, P = .03). When multivariate logistic regression analysis was used, white race was the only predictor for extracranial carotid artery lesions, and male sex was the only predictor for intracranial lesions. The cause of stroke/TIA was extracranial carotid artery disease in 8% and intracranial disease in 8% of all patients in the study. Conclusions: The distribution of cerebral atherosclerosis is influenced by race and sex but not by other vascular risk factors. In our patient population, intracranial disease is as common a cause of cerebral ischemia as extracranial carotid disease.

AB - Background and Purpose: The purpose of this study was to assess the influence of race, sex, and other risk factors on the location of atherosclerotic occlusive lesions in cerebral vessels. Previous angiographic studies of patients with stroke or transient ischemic attack (TIA) suggest that extracranial atherosclerosis is more common in whites and intracranial disease is more common in blacks. Noninvasive techniques such as duplex ultrasound, transcranial Doppler (TCD), and magnetic resonance angiography (MRA) allow vascular assessment of a more representative proportion of patients than does conventional angiography alone. Methods: Consecutive patients evaluated at a community hospital for stroke or TIA over a 2-year period were reviewed. Lesions were defined as a 50% or greater atherosclerotic stenosis by angiography, duplex ultrasound, or TCD, or a moderate stenosis by MRA. Results: Whites were more likely than blacks to have extracranial carotid artery lesions (33% versus 15%, P = .001), but the proportion of patients with intracranial lesions was similar (24% versus 22%). Men were more likely to have intracranial lesions than women (29% versus 14%, P = .03). When multivariate logistic regression analysis was used, white race was the only predictor for extracranial carotid artery lesions, and male sex was the only predictor for intracranial lesions. The cause of stroke/TIA was extracranial carotid artery disease in 8% and intracranial disease in 8% of all patients in the study. Conclusions: The distribution of cerebral atherosclerosis is influenced by race and sex but not by other vascular risk factors. In our patient population, intracranial disease is as common a cause of cerebral ischemia as extracranial carotid disease.

KW - atherosclerosis

KW - carotid arteries

KW - cerebral arteries

KW - racial differences

UR - http://www.scopus.com/inward/record.url?scp=0029803714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029803714&partnerID=8YFLogxK

M3 - Article

VL - 27

SP - 1974

EP - 1980

JO - Stroke

T2 - Stroke

JF - Stroke

SN - 0039-2499

IS - 11

ER -