Black Americans suffer from strokes at far younger ages than white patients, according to a new study. The gap is nearly a decade.
Although the overall rate of stroke has reduced over time across the population, the findings highlight concerning trends and health disparities that have seen little improvement in more than two decades.
Researchers at Brown University evaluated stroke trends using data from 17 hospitals in southern Ohio and northern Kentucky from 1993 to 2015, recording strokes for a full year from 1993 to 1994 and in 1999, 2005, 2010 and 2015 for a total of more than 9,700 cases.
They found the rate of stroke decreased from 230 cases per 100,000 people to 188 cases in that time, according to the report published Wednesday in Neurology, the medical journal of the American Academy of Neurology.
Across the 22 years the group reviewed, however, the rate of stroke among Black patients remained up to 80% higher than the rate among white patients, even after study authors adjusted for age and sex.
“We found that the rate of stroke is decreasing over time in both Black and white people – a very encouraging trend for U.S. prevention efforts,” said study author Dr. Tracy Madsen, associate professor of emergency medicine and epidemiology at Brown University. “But there was an inequity from the beginning of the study, with the rate of stroke always being higher for Black people than their white counterparts.”
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Brown researchers also found strokes occurred at younger ages over time, particularly among Black patients. Though the average age for a white person to have a stroke decreased slightly from 72 to 71, among Black people it dropped from 66 to 62.
Dr. Peter Turkeltaub, professor of neurology and rehabilitation medicine at Georgetown University Medical Center, who is unaffiliated with the study, said it is “disappointing that those disparities have been stable over the years and there hasn’t been positive movement up to 2015.”
In 2020, strokes accounted for about 1 in every 21 deaths in the United States, according to the American Heart Association. An ischemic stroke, the most common kind, occurs when the blood supply to part of the brain is blocked or reduced, preventing oxygen from reaching brain tissue and causing brain cells to die.
Turkeltaub said the risk factors for a stroke are similar to those for heart attacks, which can include hardening or narrowing of the arteries from high blood pressure, as well as diabetes and high cholesterol.
Limited access to healthy foods and medical care in some communities is a major factor in Black patients having different health outcomes, he said. Because of social and health disparities, Black people are more likely to have ischemic strokes, just as they are at higher risk of developing diabetes and obesity.
Black Americans are also more likely to die from strokes, experts say. An October study published by the Journal of Stroke and Cerebrovascular Diseases suggests that may be a result of disparities in stroke care.
Researchers analyzed more than 89,000 stroke patients across the U.S. in 2019 and found Black patients were less likely to have procedures and receive medication considered the gold standard of care for strokes.
Madsen, author of the 22-year Neurology study, noted researchers were unable to measure key social factors that contribute to racial inequities.
Because the study was focused in southern Ohio and northern Kentucky, a similar analysis could produce slightly different outcomes elsewhere in the country, Turkeltaub said. Despite these limitations, he said the study’s results are consistent with other research that suggests racial disparities among stroke victims continue to worsen.
Noting the ongoing disparities in care and outcomes, Madsen urged public health officials to take action.
“These disparities present a major ongoing public health concern,” Madsen said. “These findings are a clear, urgent call for concrete efforts to build more equitable means of stroke prevention and care.”
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