Feb. 11, 1998 Two studies by University of Maryland neurologists-one completed and one just beginning-address the higher risk of stroke that young African-Americans face.
Black men under 45 are three to five times more likely to have a stroke than white men in the same age group, a University of Maryland neurology research team reported Feb. 6. The risk of stroke in black women under 45 is four times higher than in white women of comparable age, according to Steven J. Kittner, MD, associate professor of neurology at the University of Maryland School of Medicine.
He discussed results from the Baltimore-Washington Cooperative Young Stroke Study at the 23rd International Joint Conference on Stroke and Cerebral Circulation, sponsored by the American Heart Association in Orlando.
Kittner and colleagues studied 556 men and women between 15 and 44 who were treated for strokes at the 46 hospitals in central Maryland and Washington, D.C., during 1988 and 1991. They compared race, age, gender and type of stroke.
Of 386 people with ischemic stroke, in which clots block blood vessels serving the brain, 119 were white and 267 were black. People experiencing intracranial hemorrhage-a stroke caused by excessive bleeding within the brain-included 45 white and 125 black.
After adjusting for age and gender, African-American men ran a risk of ischemic stroke 3.2 times that of white men. Their risk of intracranial hemorrhage was 5.2 times that of their white counterparts. African-American women ran 4.1 times the risk for ischemic stroke and 3.6 times the risk for intracranial hemorrhage.
Although death rates during hospitalization for stroke were similar in black and white patients, more African-Americans died because stroke occurs more commonly in that racial group, particularly at younger ages, Kittner said.
"More black people die or are disabled by strokes during their most productive years," he noted. "Now we need to focus on prevention," he said.
Kittner is heading a University of Maryland stroke prevention study, part of a five-year study sponsored by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health.
The study will compare the benefits and side effects of aspirin and ticlopidine in preventing recurring strokes in 1,800 black people who have undergone recent strokes, at 28 medical centers nationwide.
Ticlopidine is a drug that makes platelets in the blood less sticky to help prevent clots. Both treatments proved effective in preventing recurrent strokes, in studies conducted predominantly in white patients. The University of Maryland is the only medical center in the state participating in the first national study to look specifically at stroke prevention in African-Americans.
"People have assumed that whatever works in whites also works in African-Americans," Kittner said. "That is not necessarily so. The disease is different in African-Americans, and we may need different preventive therapies too."
The seven schools at the Baltimore campus of the University of Maryland train the majority of the state's health, social work and law professionals. Based on the founding campus of the University System of Maryland, those schools are: medicine, law, nursing, pharmacy, social work, dental, and graduate programs.
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