Strokes Still Hit Black Americans Earlier, Research Shows

by Denis Storey
January 16, 2024 at 9:44 AM UTC

In findings that are as unsurprising as they are tragic, new research out of Brown University has found that Black Americans suffer strokes nearly 10 years earlier than their white counterparts.

Clinical Relevance: Black Americans suffer strokes nearly 10 years earlier than their white counterparts, with higher stroke rates persisting over a 22-year period.

  • Overall stroke rates have decreased, but disparities persist, with Black people experiencing 50-80% higher rates than whites, even after adjusting for age and sex.
  • Urgent efforts are needed to address systemic, policy, and healthcare factors contributing to these health inequities.
  • Risk factors for strokes in Black Americans include high blood pressure, obesity, diabetes, smoking, and lower rates of regular exercise, emphasizing the need for targeted prevention and care strategies.

In findings that are as unsurprising as they are tragic, new research out of Brown University has found that Black Americans suffer strokes nearly 10 years earlier than their white counterparts.

Worse still, Black people invariably boast a higher stroke rate over the 22-year timeframe of the study.

The journal Neurology published the research, which found that, across demographics, stroke rates have actually fallen.

“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,” the study’s lead author, Dr. Tracy Madsen, associate professor of emergency medicine and epidemiology at Brown, explained.

Digging Deep Into the Data

The researchers looked at stroke trends across two decades, working off of data from hospitals in southern Ohio and northern Kentucky. They recorded stroke cases across a full year every five years, which worked out to about 1,950 cases per year for a total of 9,728. Comparing those numbers against U.S. Census data, the study’s authors calculated stroke incidence rates per 100,000 people.

Consequently, the researchers found that the overall rate of stroke fell from 230 cases per 100,000 people in 1993 to 188 cases per 100,000 people in 2015. For Blacks, the rates dropped from 349 to 311 and for white people, they fell from 215 to 170.

Despite that silver lining, the numbers still showed that the rate of stroke among Black people continued to be 50% to 80% higher than the rate among white people, even after they adjusted for age and sex. The discrepancy appeared starkest in younger and middle-aged Black Americans but shrank in the older age groups. It’s a difference the researchers say could be caused by the different survival rates between races.

The report found that strokes hit Blacks at an average age of 66 at the beginning of the study and at age 62 by the end. For white people, the average age was 72 at the start and age 71 by the end of the study.

“These disparities present a major ongoing public health concern,” Madsen said. “More work is clearly needed to address systemic and policy problems, as well as factors at the provider and patient levels. These findings are a clear, urgent call for concrete efforts to build more equitable means of stroke prevention and care.”

Stroke Factors Specific to Black Americans

According to the American Stroke Association, stroke risk factors in Black Americans include:

  • High blood pressure — Over half of Black adults have high blood pressure. It develops earlier in Black people and is often more difficult to manage.
  • Overweight and obesity — Almost 70% of black men and over 80% of black women are overweight or obese.
  • Diabetes — African Americans are more likely to have diabetes than non-Hispanic whites.
  • Sickle cell anemia — This common genetic disorder in African Americans remains a risk factor.
  • High cholesterol — Nearly 25% of Black people have high levels of “bad” LDL cholesterol.
  • Smoking — More than 14% of black adults smoke, increasing their risk two- to fourfold.
  • Not exercising regularly — On average, fewer than half of Black adults meet the weekly goal of at least 150 minutes of moderate activity or 75 minutes of vigorous activity (or a combination of both), which increases their risk.
  • Stress — African American adults face daily stressors that may increase the risk for stroke.

The National Institute of Neurological Disorders and Stroke funded the research.

Further Reading: 

Therapeutic Dilemma of Wake-up Stroke

Multiple Strokes in Systemic Lupus Erythematosus

Mood Disorders and Race/Ethnicity

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