July 17, 2000
Volume XXXIII, No. 28



HSC Profile

Stroke study to focus on Mexican Americans

Stroke is the third most common cause of death in the United States and a leading cause of disability, with most survivors being unable to return to work. The annual cost of stroke is estimated at $40 billion a year. 

Dr. Benavente

Dr. Oscar Benavente, neurology, is focusing his research on a particular type of stroke called small subcortical (lacunar) stroke that disproportionately affects Hispanics and African Americans. A subtype of ischemic stroke, lacunar strokes result from blockage of small arteries in the brain. 

"Lacunar strokes are responsible for a large proportion of ischemic strokes, have a tendency to affect young people, and show a high recurrence rate that may lead to vascular dementia, and con-sequently to severe disability," said Dr. Benavente. 

He and Dr. Robert Hart have designed a project called Secondary Prevention for Small Subcortical Strokes (SPS3), which has been approved for funding by the National Institutes of Health (NIH). The pilot study, which began in September 1999, is expected to be completed in 2001. A multicenter clinical trial will follow that will involve some 20 centers across the country and approximately 1,000 patients. 

Since he began studying stroke in 1988 in Canada, Dr. Benavente has been interested in the specific problem of lacunar strokes in Hispanics. Hispanics are a heterogeneous ethnic group, represented by Mexican Americans in the Southwest, particularly in Texas. It is estimated that by the year 2010 the Hispanic population will total more than 20 million, making it the fastest growing minority grouping in the country. 

"In my work, I was able to observe the high prevalence of lacunar stroke in this population and its relationship with risk factors such as hypertension and diabetes. Despite the impact of these type of strokes, little is known about how to prevent their recurrence and the incidence of vascular dementia in this group of patients. In addition, the proper management of hypertension following a lacunar stroke is not being properly addressed," Dr. Benavente said. 

The SPS3 project will address that question as well as others that have not been widely investigated, such as the effect of antiplatelet therapy in this group of stroke survivors, prevention of vascular dementia and, in particular, the characterization of stroke in Mexican Americans. 

Most of the research study patients in San Antonio will be Mexican American," Dr. Benavente said. "I strongly believe that this project will encourage and make possible additional research about this common stroke subtype, and will have a significant impact on the delivery of health care in the United States, particularly among the Hispanic population." 

Drs. Benavente and Hart are accepting study participants and encourage people who have suffered a small subcortical stroke to apply. 

Interested individuals may call the Division of Neurology at 617-5161 for more information.