Paradoxical increase in stroke mortality among Asian Indians in the United States.

OBJECTIVE To better characterize the stroke mortality and risk factors among Asian Indians by using U.S. multiple-cause-of-death and National Health and Interview Survey data. METHODS Age-adjusted fatal stroke incidence, stroke rate ratio with 95% confidence interval, and average annual percentage change (APC) over 10 years were calculated. RESULTS The annual incidence of stroke mortality in 2000 was lowest among Asian Indians (88 per 100,000) followed by American Indians and Alaska Natives (112 per 100,000), whites (301 per 100,000) and African Americans (312 per 100,000). Significantly lower rates of hypertension and cigarette smoking in Asian Indians in 2000-2001 (compared with whites) explained the lower rates of stroke mortality. The APC increase over subsequent 10 years was 13.5%, 0.9%, -2.5%, and -2.9% for Asian Indians, American Indians and Alaska Natives, whites, and African Americans, respectively. CONCLUSIONS There is a paradoxical increase in stroke mortality among Asian Indians over the last 10 years in contrast to other population subsets.