Young African-Americans Run Higher Risk Of Stroke

Black men under 45 are three to five times more likely to have a strokethan white men in the same age group, a University of Maryland neurologyresearch team reported Feb. 6. The risk of stroke in black women under 45is four times higher than in white women of comparable age, according toSteven J. Kittner, MD, associate professor of neurology at theUniversity of Maryland School of Medicine.

He discussed results from the Baltimore-Washington Cooperative YoungStroke Study at the 23rd International Joint Conference on Stroke andCerebral Circulation, sponsored by the American Heart Association inOrlando.

Kittner and colleagues studied 556 men and women between 15 and 44 whowere treated for strokes at the 46 hospitals in central Maryland andWashington, D.C., during 1988 and 1991. They compared race, age, genderand type of stroke.

Of 386 people with ischemic stroke, in which clots block blood vesselsserving the brain, 119 were white and 267 were black. Peopleexperiencing intracranial hemorrhage-a stroke caused by excessivebleeding within the brain-included 45 white and 125 black.

After adjusting for age and gender, African-American men ran a risk ofischemic stroke 3.2 times that of white men. Their risk of intracranialhemorrhage was 5.2 times that of their white counterparts. African-American women ran 4.1 times the risk forischemic stroke and 3.6 times the risk for intracranial hemorrhage.

Although death rates during hospitalization for stroke were similar inblack and white patients, more African-Americans died because strokeoccurs more commonly in that racial group, particularly at younger ages,Kittner said.

"More black people die or are disabled by strokes during their mostproductive 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 ofNeurological Disorders and Stroke of the National Institutes of Health.

The study will compare the benefits and side effects of aspirin andticlopidine in preventing recurring strokes in 1,800 black people whohave undergone recent strokes, at 28 medical centers nationwide.

Ticlopidine is a drug that makes platelets in the blood less sticky tohelp prevent clots. Both treatments proved effective in preventingrecurrent strokes, in studies conducted predominantly in white patients.The University of Maryland is the only medical center in the stateparticipating in the first national study to look specifically at strokeprevention in African-Americans.

"People have assumed that whatever works in whites also works inAfrican-Americans," Kittner said. "That is not necessarily so. Thedisease is different in African-Americans, and we may need differentpreventive therapies too."

The seven schools at the Baltimore campus of the University of Marylandtrain the majority of the state's health, social work and lawprofessionals. Based on the founding campus of the University System ofMaryland, those schools are: medicine, law, nursing, pharmacy, socialwork, dental, and graduate programs.