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24 Background: We have previously estimated the  stroke incidence rate in the US to be 731,000/yr using data from blacks  in Cincinnati and whites in Rochester, MN. We present preliminary  stroke incidence rates using data from white and black residents of the  Greater Cincinnati metropolitan area.Methods: All strokes  between 1/1/93–6/30/94 for blacks and 7/1/93–6/30/94 for whites were  identified by surveillance of ICD-9 discharge codes from hospitals  (430–438, 1o or 2o ), coroner’s records, and  surveillance of outpatient settings including emergency departments,  hospital based outpatient clinics, family practice centers, and a  random sampling of primary care offices and nursing homes. More than  17,000 potential stroke/TIA events were screened. During abstraction,  research nurses determined stroke subtype, using strict criteria.  Overall agreement on stroke subtype and diagnosis between study nurses  and physicians is 87% (κ = 0.71). The incidence rates per  100,000 for stroke were calculated and standardized to the 1990 total  U.S. population.Results: Rates of first-ever stroke among  blacks were consistently higher than rates for whites for all stroke  subtypes (Table). The overall rate of first-ever and recurrent stroke  was 291 per 100,000.Conclusion: Based on these incidence  rates, derived from a large, population-based study, we estimate that  760,000 strokes will occur in the US in the year  2000.

Incidence Rates of Stroke for Blacks and Whites: Preliminary Results from the Greater Cincinnati/Northern Kentucky Stroke Study