Young Blacks, Hispanics More Prone to Stroke than Young Whites

The incidence of stroke is higher among blacks and Hispanics ages 20 to 44 than among young whites, according to a study in today's rapid access issue of Stroke: Journal of the American Heart Association.

While studies have shown that blacks and Hispanics are more likely than whites to suffer stroke in general, this is the first study to compare stroke incidence among young blacks, Hispanics and whites living in the same community. Stroke, the third leading cause of death in the United States, is most prevalent among the elderly, but still occurs in about 23 of every 100,000 people between ages 20 and 44, according to the researchers.

Researchers in this study analyzed all the cases of first stroke that occurred in Northern Manhattan from 1993 to 1997 to determine how frequently stroke was occurring among the younger population. They also compared stroke and stroke subtypes among various ethnic, gender and age groups, according to the study's lead author Bradley S. Jacobs, M.D., assistant professor in the Comprehensive Stroke Program of the Department of Neurology, Wayne State University School of Medicine in Detroit, Mich.

They identified 74 cases of first stroke in young patients during the four-year study. Of these, 47 percent were women, 12 percent were black, 80 percent were Hispanic and 8 percent were white. "That speaks to the large Hispanic population in Northern Manhattan," Jacobs says.

In general, the risk of having any stroke was greater in blacks and Hispanics compared to whites. Stroke was 2.4 times more likely to occur in blacks compared to whites and 2.5 times more likely to occur in Hispanics versus whites.

"This extends our observations of the race-ethnic disparities in stroke risk to younger people where a stroke can be more devastating," says Ralph L. Sacco, M.D., principal investigator of the Northern Manhattan Stroke Study (NOMASS).

They also looked at type of stroke -- cerebral infarction, a stroke in which blood flow to the brain is blocked, and hemorrhagic, which results from a ruptured blood vessel in the brain.

Young men were 3.7 times more likely to have intracerebral hemorrhage than women in the same age group. They found that 38 percent of blacks who had a stroke died within 30 days, versus 16 percent of Hispanics. No whites died in that period. Jacobs notes, however, that the number of deaths were small, making it difficult to judge the significance of these differences.

The results of the study will help to direct future research to look at why these particular populations are having stroke more frequently, Jacobs says. Doctors and young people should also recognize these numbers as an indication that stroke is a major public health concern, even among younger patients.

"Young people should be aware of the risk factors, signs and symptoms of stroke," he says. "Correctable risk factors include high blood pressure, diabetes, high cholesterol and cigarette smoking."

According the American Stroke Association, stroke warning signs are sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination and sudden, severe headache with no known cause.

Co-authors are Bernadette Boden-Albala, M.P.H., and I-Feng Lin, Ph.D.

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