Stroke and African Americans

Stroke African Americans

Summary

A stroke is a potentially life-threatening event in which part of the brain is deprived of adequate oxygen. African Americans are at greater risk of stroke than any other ethnic group. African Americans also have both a higher likelihood of stroke at an earlier age and a greater risk of overall mortality compared to other ethnic groups.

Why African Americans have an increased risk of stroke when compared to other groups is not well-understood. Some studies have suggested that the effects of racism and poverty may play a role. In addition, African Americans are more likely to have medical and other risk factors associated with increased risk of stroke, such as diabetes, high blood pressure, sickle cell anemia, smoking and obesity.

Signs and symptoms of stroke can vary, depending on the area of the brain affected by the stroke. Symptoms of stroke can occur suddenly and can include numbness or weakness on one side of the body, language difficulties, such as problems with speaking or understanding, and dizziness.

A stroke is a medical emergency. Anyone experiencing the symptoms of a stroke should be urged to call 9-1-1 immediately. Optimal stroke therapy is dependent on rapid treatment to re-establish blood flow to the brain. Once the patient is stabilized, the complete medical evaluation of a patient who has had a stroke can take several days. Patients who survive a stroke often need to undergo stroke rehabilitation to adequately manage the long-term effects of the event. Stroke is the third-leading cause of death and the leading cause of adult disability in the United States. However, 80 percent of strokes can be prevented by making lifestyle changes and taking proper precautions, according to the National Stroke Association. These include eating a well-balanced diet, engaging in regular exercise and not smoking.

About stroke and African Americans

Stroke is a potentially life-threatening medical problem that affects people of all races. However, African Americans are at greater risk of stroke than any other ethnic group. African Americans are twice as likely to die from stroke compared to Caucasians, according to the National Stroke Association.

A stroke occurs when blood and oxygen to brain cells are suddenly cut off. This usually occurs as a result of blood clots that block arteries, or a gradual buildup of fatty deposits that cause similar blockage (ischemic stroke). Strokes also can occur when weak spots in blood vessel walls cause the vessel to suddenly burst (hemorrhagic stroke).

Patients who experience strokes may have disabilities that range from mild, moderate to severe. More serious symptoms include paralysis, difficulty thinking and speaking, and emotional problems. In some cases, strokes can be fatal.

The risk of stroke is greater – and the recovery process is slower – in African Americans compared to white Americans, according to the National Institutes of Health. African Americans also have both a higher likelihood of stroke at an earlier age and a greater risk of overall mortality compared to whites and other racial groups.

Risk factors and causes of stroke

Scientists do not completely understand why African Americans are at increased risk of stroke in comparison to other groups. Some studies have suggested that socioeconomic factors related to racism and poverty (e.g., lack of adequate health care, poor diet, increased stress) may play a role. Genetic factors also may be associated with the increased incidence of stroke among African Americans.

In addition, African Americans are more likely to have risk factors known to be closely associated with the occurrence of strokes. These include:

  • High blood pressure (Hypertension). Hypertension is the leading risk factor associated with stroke. About one in three African Americans has hypertension, which is defined by the National Stroke Association as systolic (heart pumps)/diastolic blood pressure (heart at rest) of 140/90 or higher. The rate of hypertension among African Americans is among the highest for any group in the world, according to the American Heart Association. African Americans also tend to develop hypertension at an earlier age and have a higher average blood pressure than other ethnic groups.
  • Diabetes. Individuals with diabetes are at increased risk for stroke because excess glucose (blood sugar) or insulin (a hormone that regulates glucose) in the bloodstream can damage the arteries that deliver oxygen to the brain. In addition, individuals with diabetes are more likely to have high blood pressure and high blood cholesterol, and to be overweight. African Americans have a higher risk of developing diabetes than other ethnic groups.
  • Sickle cell anemia. In this disease, the body makes abnormally shaped red blood cells that can block a blood vessel to the brain, resulting in stroke. The abnormal red blood cells also carry less oxygen. African Americans are at much greater risk of this disease than other ethnic groups.

African Americans also are more likely than the general population to be overweight or obese and to smoke. These factors also increase the risk for stroke. Other risk factors for stroke include male gender, age older than 55, having a family history of stroke and residence in the southeastern part of the United States. 

A history of certain medical conditions also raises the risk of stroke. These include:

  • Atrial fibrillation
  • Carotid artery disease
  • Heart disease
  • High blood cholesterol levels
  • Transient ischemic attack (TIA)

Signs and symptoms of stroke

Signs and symptoms of stroke may vary, depending on the area of the brain affected by the stroke. They frequently come on suddenly and may include:

  • Numbness and/or weakness on one side of the body
  • Confusion
  • Difficulty walking or seeing
  • Dizziness
  • Headaches
  • Loss of balance
  • Nausea
  • Trouble speaking or understanding speech (aphasia)

Diagnosis and treatment methods for stroke

A stroke is a medical emergency. Individuals experiencing symptoms of a stroke should call 9-1-1 immediately. Aspirin should not be presumptively taken for a stroke, as it could make a hemorrhagic stroke worse. Receiving rapid medical evaluation and treatment after a stroke can help to reduce stroke-related disability.

When a patient shows symptoms of a stroke, the physician will promptly evaluate the patient’s medical history and perform tests such as a computed axial tomography (CAT) scan. The CAT scan can help the physician determine whether the patient is having a cerebral hemorrhage or an ischemic stroke caused by cerebral ischemia. This information determines the next step in emergency treatment. The CAT scan may also help the physician locate the exact position of the damage in the brain.

Stroke therapy relies on rapid treatment after the stroke to re-establish blood flow to the brain. Once the patient is stabilized, a complete evaluation of the effects of the stroke can take several days. People who survive a stroke often need to undergo treatment (e.g., stroke rehabilitation, physical therapy) to deal with some of the long-term effects of the event.

Prevention methods for stroke

Stroke is the third-leading cause of death and the leading cause of adult disability in the United States. However, 80 percent of strokes can be prevented by making lifestyle changes and taking proper precautions, according to the National Stroke Association. These include:

  • Quitting smoking. Smokers have two times the risk of stroke compared to nonsmokers. People who give up tobacco products immediately lower their risk of stroke. Women who smoke and use oral contraceptives (birth control pills) greatly increase their risk of stroke.
  • Drinking alcohol in moderation. Studies show that drinking a single alcoholic beverage each day may lower the risk of stroke for certain people. However, it is important to remember that excessive alcohol consumption can pose health risks. As a general rule, most experts advise that not drinking at all is the best option.
  • Maintaining a healthy diet. Diets low in sodium and fat help patients lower their blood pressure and the risk of stroke. Good food choices include fruits, vegetables, lean meats (e.g., chicken, fish) and foods rich in fiber.
  • Maintaining optimal body weight. Obesity significantly raises the risk of stroke and heart disease.
  • Taking blood pressure and cholesterol medications regularly. For these medications to be effective, they should be taken exactly as prescribed by a physician.
  • Engaging in regular exercise. Most experts advise adults to exercise for at least 30 minutes five or more days each week. This can include activities such as brisk walks, yard work or bicycle rides.
  • Maintaining control over blood sugar levels. Diabetes is a risk factor for stroke. Patients with diabetes who manage blood sugar levels lower the risk of diabetes-related medical conditions including stroke.
  • Seeking treatment for sleep apnea. This condition, which causes temporary breathing interruptions during sleep, may raise the chance of having a heart attack or stroke.
  • Positively coping with stress. Finding positive methods to cope with stress can lower lifestyle associated risks of stroke. These methods may include physical activity, meditation and talking with friends.

Questions for your doctor regarding stroke

Preparing questions in advance can help patients have more meaningful discussions with healthcare professionals regarding their condition. Patients may wish to ask their doctor the following questions related to stroke and African Americans:

  1. As an African American, do I have more risk factors for stroke than individuals from other ethnic groups? Why?
  2. Are there any tests available to me that would indicate whether or not I am at risk for a stroke?
  3. Does my lifestyle affect my stroke risk? What changes can I make to decrease my chances of having a stroke?
  4. Are there any medical options available to me to prevent a possible stroke?
  5. Should I alter any of the medications I am currently taking?
  6. If I have had a stroke, are my children at increased risk for having a stroke?
  7. What should I do if I think I am having a stroke?
  8. What should I do to prevent a stroke if I have diabetes?
  9. How should I protect myself from a stroke as an African American woman?
  10. Could a stroke affect my pregnancy? How?
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