Stroke Risk among Chinese Immigrants in New York City

Background: Little is known of risk factors for stroke among Chinese immigrants to the United States. We have conducted a case–control study to identify risk factors for stroke among foreign-born Chinese in New York City. Methods: From September 2000 to June 2003, 187 sequential stroke cases (44 hemorrhagic) and 204 controls matched on age, gender, and years since immigration were recruited from New York Downtown Hospital, which was located next to New York City Chinatown. Risk factor status was assessed by questionnaire interview and medical chart review, which included clinical factors, sociodemographic characteristics, personal and family histories, and behavior and lifestyle factors, as well as behavioral changes after immigration to the United States. Results: For cases and controls, mean ages were 74.8 and 74.7 years, 47.3% of cases and 47.5% of controls were male, and mean years since immigration to the United States were 26.7 and 26.8, respectively. Sociodemographic characteristics and behavioral pattern including cigarette smoking, exercise, and usage of special diet or dietary supplements were similar between cases and controls. However, stroke patients were more likely to have hypertension (76% vs. 59%, p≤0.001), increased blood pressure (165/84 mmHg vs. 140/74 mmHg, p≤0.001) and left ventricular hypertrophy (LVH) (10.1% vs. 4.3%, p≤0.05), and less likely to consume poultry (odds ratio 0.80, 95% confidence interval (CI) 0.59–1.00); fish (0.70, 95% CI 0.42–0.96), fruit and vegetable juice (0.83, 95% CI 0.70–0.95), and grains (0.79, 95% CI 0.62–0.96) than were controls. Conclusion: Among Chinese immigrants in New York City, as in general population, poor controlled hypertension was related to the risk of stroke. Therefore, Chinese immigrants presenting with hypertension and/or a family history of hypertension should be detected and followed up regularly to monitor the blood pressure level. In addition, difference in food intake between stroke and control patients may present an opportunity for behavior intervention to prevent stroke.