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U.S. Has Racial Gap in Stroke Rate

Study Shows African-Americans More Likely Than Whites to Have Strokes
By
WebMD Health News
Reviewed by Louise Chang, MD

March 1, 2010 (San Antonio) -- The first national snapshot of the racial gap in stroke rates shows that African-Americans are more likely to suffer from the debilitating condition than whites.

The study of over 26,000 people aged 45 and older from across the U.S. may help to explain why African-Americans are more likely to die from stroke than whites, says researcherVirginia J. Howard, PhD, associate professor of epidemiology at the University of Alabama School of Public Health in Birmingham. 

"It has long known that blacks die at a higher rate from stroke than whites, but there has been little data explaining why. The analysis suggests that the higher rate of stroke in the African-American population may be one of the reasons," Howard says.

The study involved 26,618 people enrolled in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study. About 40% were African-American and the rest were white.

Over a four-year period, 352 of them suffered a stroke.

"There were higher rates of strokes in blacks in almost every age group, especially among those aged 45 to 54. This younger age group was two-and-one-half times more likely to have had a stroke than whites," Howard tells WebMD.

The study, presented here at a meeting of the American Stroke Association (ASA), showed that:

  • Among people aged 45 to 54, there were 192 strokes per 100,000 African-Americans vs. 74 strokes per 100,000 whites.
  • Among people aged 55 to 64, there were 387 strokes per 100,000 African-Americans vs. 204 strokes per 100,000 whites.
  • Among people aged 65 to 74, there were 713 strokes per 100,000 African-Americans vs. 439 strokes per 100,000 whites.
  • Among people aged 75 to 84, there were 1,095 strokes per 100,000 African-Americans vs. 925 strokes per 100,000 whites.

African-Americans aged 85 and older were the only ones exempt from the trend. In this age group, there were 835 strokes per 100,000 African-Americans vs. 1,131 strokes per 100,000 whites.

Stroke Death Patterns

Deaths from stroke follow the same pattern, with blacks consistently more likely to have a fatal stroke than whites until the age of 85, Howard says.

The racial gap in stroke rates alone doesn't explain the disparity in stroke death rates, says ASA spokesman Michael Sloan, MD, director of the stroke program at the University of South Florida in Tampa.

"Blacks also have less access to care, particularly preventive care. In general, they have less knowledge of stroke signs and risk factors," he tells WebMD.

"African-Americans are less likely to have regular follow-up exams for management of risk factors. We know that African Americans have more diabetes and high blood pressure," both of which are major stroke risk factors, Howard adds.

The new study also confirmed that people living in the so-called "stroke belt" states -- North Carolina, South Carolina, Georgia, Alabama, Arkansas, Louisiana, Tennessee and Mississippi -- are more likely to suffer strokes than people living in other areas of the U.S.

"The message," Howard says, "is that certain subgroups are more at risk and need to pay serious attention to their risk factors to prevent stroke. No one should assume that just because their grandmother died from stroke, they will die from stroke. There are steps you can take, such as eating right and exercising, to lower risk," she says.

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