The Framingham Heart Study estimated the lifetime risk of stroke to be 1 in 6 or more for middle-aged adults.30 Low Birth Weight Low birth weight has been associated in several populations with risk of stroke in later life. Stroke mortality rates among adults in England and Wales are higher among people with lower birth weights.31 The mothers of these low-birth-weight babies were typically poor, were malnourished, had poor overall health, and were generally socially disadvantaged.31 A similar study compared a group of South Carolina Medicaid beneficiaries <50 years of age who had stroke with population The odds of stroke was more than double for those with birth weights <2500 g compared with those weighing 4000 g (with a significant linear trend for intermedi- ate birth weights). A US nationally representative longitudinal study found an odds ratio (OR) of 2.16 (P<0.01) for low-birth- weight babies compared with normal-birth-weight babies for the risk of stroke, MI, or heart disease by 50 years of age.33 Differences in birth weight may reflect differences in birth- place, and these geographic differences may relate to differ- ences in stroke mortality.34 Whether the association of birth weight with stroke risk is causal remains to be clarified. Race/Ethnicity Epidemiological studies support racial and ethnic differences in the risk of stroke.35 and some Hispanic/Latino have a higher incidence of all stroke types and higher mortality rates compared with whites. 