Original Contributions Stroke in Blacks

In an attempt to answer unresolved questions and to suggest directions for future research concerning stroke in black populations, data from the National Center for Health Statistics were examined and published studies were reviewed. Stroke was the third leading cause of death among U.S. blacks in 1982, accounting for 18,698 deaths, 8.25 % of the total. Black men aged 35-74 years were 2.5 times and black women 2.4 times as likely as whites to die of stroke. A long-term decline in stroke mortality rates continued through 1982, with the declines since 1968 probably due to improved hypertension control. Data on morbidity trends are lacking. About 7 % of black men and 11 % of black women in the U.S. noninstitutionalized population aged 65 and over reported having had a stroke in 1977, black women having the highest prevalence of any group. In several studies, black women had higher incidence rates of stroke than white women in each age group. Black men had higher incidence rates than whites up to age 75 years. Survivorship and outcome following stroke may have been poorer in blacks than in whites. Advanced age and elevated blood pressure were the only putative risk factors for stroke for which published data were adequate to firmly establish the association in blacks. Thus, data are needed to examine trends in stroke incidence and survivorship in blacks and to assess the relation of many variables to the risk of stroke. (Stroke 1988;19:l-9) Stroke is the third leading cause of death in U.S.blacks.1 It has long been recognized that U.S.blacks suffer mortality and morbidity from stroke at rates far in excess of those of whites23; stroke death rates of U.S. blacks have been among the highest in the world.3 Despite these facts, many questions re-main regarding the etiology of stroke in blacks and the basis for racial differences in stroke occurrence. This report examines data from the National Center for Health Statistics and reviews epidemiologic studies of stroke in black populations in an attempt to answer these questions and to suggest directions for future research