NEW ORLEANS, Feb 14 (Reuters Health) - African Americans, American Indians and Alaska Natives, Asian and Pacific Islanders, and Hispanic adults are all more likely to die from stroke than white adults, researchers from the Centers for Disease Control and Prevention (CDC) said Friday.
The report correlates with findings reported here Friday by a researcher from Michigan. Speaking at the Annual American Stroke Association, he said that African-Americans younger than 55 years of age are more likely than their Caucasian counterparts to experience lacunar strokes and strokes due to intracranial large vessel atherosclerosis.
The CDC researchers released their findings based on 1997 death certificate data in the Morbidity and Mortality Weekly Report for February 11th. In the report, Dr. Carma Ayala and colleagues showed that African-Americans aged 35 to 54 years are four times more likely than white adults of the same age to die of stroke. American Indians and Alaska Natives aged 35 to 44 years were almost twice as likely as their white counterparts to die of stroke.
"There is a multitude of reasons these people are at risk," Dr. Ayala told Reuters Health. The excess deaths can be partially attributed to risk factors such as hypertension, cigarette smoking, diabetes and lack of physical activity, she said.
"There are also socioeconomic factors," she added, including absence of health insurance, and lack of trust of the medical system.
In a separate study, Dr. Seemant Chaturvedi, and colleagues, from Wayne State University, in Detroit, studied stroke risk factors in 59 African-American and 53 age- and sex-matched Caucasian patients, all of whom were aged 55 years and younger.
At the meeting, Dr. Chaturvedi reported that 38% of African-American patients had hypertension, compared with 14% of the Caucasian patients, and that 21% of African-Americans had two or more risk factors, compared with 7% of Caucasians.
He said that 10% of African-Americans had intracranial large-vessel and lacunar strokes compared with 2.7% of Caucasian patients, a statistically significant difference. Not significant was the difference between the prevalence of cardioembolic strokes: 11% of African-Americans suffered them compared with 5% of Caucasians.
"We have to move the clock back," said Dr. Phillip B. Gorelick of Rush Presbyterian St. Luke's Medical Center in Lincolnwood, Illinois, and moderator of the symposium in which these findings were presented. "The overall issue here is that we need to educate people in the African-American community and teach them ways in which they can change their lifestyles to reduce their risk of stroke.
MMWR 2000;49:94-97.
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