Five-Year Outcome of a Stroke Cohort in Martinique, French West Indies Etude Realisee en Martinique et Centree sur l'Incidence des Accidents vasculaires cerebraux, Part 2

Background and Purpose-Limited information exists on stroke among black populations outside the United States and United Kingdom. Part 1 of the Etude Realisee en Martinique et Centree sur l'Incidence des Accidents vasculaires cerebraux (ERMANCIA) provided strong epidemiologic data on the incidence of first-ever stroke in a black Caribbean population and showed a 40% greater incidence of stroke in Martinique than in continental France. In ERMANCIA part 2, we evaluated the long-term outcomes of our cohort. Methods-Survivors of a first stroke from this prospective, community-based, stroke incidence study were reassessed at 5 years according to standardized procedures and criteria, including the modified Rankin scale, Barthel Index, Montgomery-Asberg Depression-Rating Scale, Mini-Mental State Examination, treatment compliance, and blood pressure control. Results-Of the 293 survivors of the original 580 (50.5%) patients who were still alive 5 years after stroke, 262 (89.4%) were assessed. Among these survivors, 66.4% were functionally independent and 43% were completely autonomous for activities of daily living, but 25.8% were depressed and 58.9% were cognitively impaired. Only 50 of 170 (29.4%) of the hypertensive patients achieved their target blood pressure. Conclusions-These results highlight the very poor blood pressure control and the very high rate of cognitive impairment in Martinican patients after stroke. As a consequence, a poststroke prevention network was established in Martinique. (Stroke. 2010;41:594-599.)