Ethnicity a risk factor? The relation between ethnicity and large- and small-vessel disease in White people, Black people, and Asians within a hospital-based population

Previous studies suggest that in patients with ischaemic stroke, White people often present with large-vessel and Black people with small-vessel strokes. This study investigates the relation between large- and small-vessel disease, and ethnicity in White, Black, and Asian patients in Amsterdam, the Netherlands. In a hospital-based population of 668 patients ethnicity was determined by self-identification. The relation between ethnicity and carotid stenosis, as an indicator of large-vessel disease, was determined using univariate analysis, and adjusted for age, gender, hypertension and smoking. Subsequently the relation between ethnicity and lacunar infarcts, as a manifestation of small-vessel disease, was investigated. The odds ratio for having carotid stenosis, compared to White patients, was 0.55 (0.23-1.33) for Blacks, 0.53 (0.18-1.52) for Asians, and 0.64 (0.14-2.85) for other ethnicities. The adjusted odds ratio for a non-White patient compared to a White patient was 0.44 (0.19-1.02) (P = 0.05). The non-White patients more often presented with lacunar infarcts compared to Whites. We found an association between White patients and the presence of carotid artery stenosis. Not only in Black but also in Asian patients the association with carotid artery stenosis was substantially lower. In the non-White population there was an association with lacunar infarcts compared to Whites