Differences in risk factors in black and white patients with acute ischaemic stroke

ABSTRACT

BACKGROUND: UK black subjects have an increased incidence of stroke and death from stroke as compared with white subjects. Such differences may reflect differences in risk factors. Methods: Details on demographics and risk factors were recorded prospectively on all patients with ischaemic stroke admitted to King's College Hospital (KCH) during the three year period June 1993 to May 1996. KCH serves a population a population of 220,000 of whom 15 percent are black about 70 percent of stroke patients are admitted. Patients who were not CT scanned (9 percent) were excluded. RESULTS: 666 patients were admitted with ischaemic stroke; 542(18 percent) were white and 124(19 percent) black. Black patients were younger, median 66 (12) years versus 73 (12) years, p<0.001, and had a slight male preponderance (52 percent versus 47 percent, p=0.25). Blacks had an increased prevalence, as compared with whites of certain vascular risk factors including hypertension (67 percent versus 51 percent, p=0.001) and diabetes mellitus (41 percent versus 16 percent, pblood pressure on admission, 120(25) mmHg versus 112(22)mmHg,p=0.004. In contrast, blacks were less likely to have a reported history of ischaemic heart disease (16 percent versus 27 percent, p=0.015) or smoking (17 percent versus 28 percent, p=0.025), and had less atrial fibrillation on admission (16 percent versus 24 percent, p=0.061).

CONCLUSION:

South East London black and white patients with acute stroke differ with respect to risk factor profilesblack patients have increasded rates of hypertension and diabetes; in contrast they are younger and have less ischaemic heart disease and atrial fibrillation. Such differences may explain, in part differences in the observed stroke incidence and outcome between blacks and whites.(AU)