Disparities in Ischemic Stroke Subtypes and Risk Factors between Taiwanese Aborigines and Han Chinese in Taitung, Taiwan

Abstract

Background: There are two major ethnic categories in Taiwan, i.e., the Han Chinese (98%) and the Taiwanese Aborigines (2%). The interethnic disparities in ischemic stroke etiological subtypes, conventional and behavioral vascular risk factors were unknown. Methods: From June 2007 to May 2009, a prospective stroke registry was conducted by a referral hospital in Taitung, Taiwan. Using the database, the interethnic disparities were examined by univariate analyses, followed by multivariate analysis of the ischemic stroke subtype [by TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification] with significant difference between the two ethnicities. Results: We included 433 acute ischemic stroke patients, comprising 302 Han Chinese (70%) and 131 Aborigines (30%). The Taiwanese Aborigines are more likely to be illiterate and living in rural areas (both p < 0.001); they are also more likely to have atrial fibrillation (p = 0.018), and to engage in alcohol drinking (p = 0.046) and areca nut chewing (p < 0.001), but less likely to have diabetes mellitus (p = 0.022). Univariate analysis shows higher prevalence of cardioembolism among the Taiwanese Aborigines. However, ethnicity is not one of the independent variables of cardioembolism, which include atrial fibrillation [odds ratio (OR) = 28.04; 95% confidence interval (CI), 13.39–58.72)], hyperlipidemia (OR = 0.46; 95% CI, 0.23–0.95), and areca nut chewing (OR = 2.85; 95% CI, 1.21–6.72). Conclusion: Risk factors differ between the Han Chinese and the Taiwanese Aborigines, and areca nut chewing correlates with cardioembolic stroke. Future measures for stroke prevention should take these factors into consideration.

Keywords

• areca
• atrial fibrillation
• betel
• cardioembolism
• ethnic