Duplex Doppler and Spectral Flow Analysis of Racial Differences in

We compared carotid artery disease in 99 black and 106 white patients using duplex ultrasonography (B-mode imaging and Doppler spectral analysis). Blacks had significantly less stenosis of the extracranial internal carotid artery than whites. Among the risk factors investigated, hypertension alone, ischemic heart disease, diabetes mellitus, and smoking failed to explain the racial difference. Although carotid stenosis of>40 % correlated significantly with age in both races (/7=0.001 in whites and /;=0.005 in blacks), blacks had significantly less carotid stenosis of any degree even when age was taken into account Multivariate analysis showed that race is a significant and independent risk factor for carotid stenosis (p<0.0001). Hypertension interacting with race was also significant Our results require verification in population-based studies. Carotid duplex ultrasonography offers a noninvasive method for carrying out such studies. (Stroke 1990^1:740-744) Racial differences in pathology of the intracra-nial and extracranial arteries have beenreported among patients with ischemic stroke.1-9 The importance of disease of the extracra-nial internal carotid artery as a cause of ischemic stroke was appreciated early in whites.10 Later