Racial Disparity in Stroke Death Could Be Reduced

To reduce the disparity in stroke mortality between blacks and whites, interventions should be focused on preventing stroke among blacks, a study found.

The study, conducted by George Howard, DrPhD, of the University of Alabama at Birmingham, and colleagues, was published in the journal Stroke on June 2, 2016.

The researchers reviewed existing data and concluded that “the key to reducing the black disparity in stroke mortality is through risk factor prevention or improved risk factor control to prevent strokes in blacks rather than improved care of blacks once stroke has occurred.” They state the goal of the current report as being “to confirm the findings in a national cohort of black and white participants.”

Using the REGARDS study, a longitudinal cohort of 30,239 participants, who were 45 years or older and either black or white, the researchers investigated two main points: black-white disparities in stroke incidence and the black-white difference in fatality within 30 days of stroke. Follow up information was available for 29,682 (98%) of the participants. “During an average follow-up of 6.8 +/-2.7 years, there were 1168 strokes; of which 242 were fatal,” report the researchers.

The researchers found that the risk of stroke increased 61% with each decade of age, adding “but there was no evidence that either race or sex was associated with case fatality.” The researchers conclude that the data they collected and analyzed supports previous studies that have shown increased stroke mortality among blacks is due to the fact that black people have more strokes, and, they say, “black-white differences in case fatality is at most a minor contributor.”

“Hence,” say the researchers, “reducing the black-to-white disparity in stroke mortality will require further understanding and interventions to reduce the higher incidence of stroke in blacks.” Aiming stroke prevention interventions at the population in which more stroke occurs through public health programs and in partnership with primary care physicians is the best way to reduce stroke mortality in that population.

The researchers conclude that investigating the reasons there is a higher prevalence of risk factors for stroke among the black population could help reduce stroke, adding that “differential susceptibility to risk factors, disparities in the control and treatment of risk factors, socioeconomic inequities, and novel or emerging risk factors, where blacks have a disadvantage” offer paths to understanding why there is more stroke among blacks, as well as ways of reducing the risk of stroke.