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Black Stroke Survivors Have Higher Blood Pressure, Increased Risk

Chelsea Kidwell

Dr. Chelsea Kidwell led the research, conducted through the Georgetown University Medical Center (GUMC) Stroke Disparities Program.

August 30, 2012 – African Americans who survived a stroke caused by bleeding in the brain had higher blood pressure than white people a year later, according to a study published today in the journal Stroke.

The finding might help explain why black people have a greater risk of suffering a second stroke than whites.

The research, part of the Georgetown University Medical Center (GUMC) Stroke Disparities Program led by Dr. Chelsea Kidwell, was designed to examine racial and ethnic differences in strokes, called intracranial hemorrhage or ICH.

Tailored Intervention

ICHs accounts for 10 percent of all strokes, but carry a death rate of about 40 percent in the first month after the stroke, much higher than other types of stroke. High blood pressure is the most important modifiable risk factor associated with ICH.

“Identifying how prevalent high blood pressure is this far out from a stroke can help us tailor intervention programs that can truly make a difference,” explains Kidwell, a professor in GUMC’s neurology department and director of its Stroke Center.

Kidwell’s study included 162 patients, 77 percent of whom were black, 53 percent male and an average age of the 59. All had been treated for an initial stroke at hospitals in the Washington, D.C., area.

Half of the patients had high blood pressure a year after their stroke, even though most were taking medication to help lower their blood pressure. Of those, 63 percent of black patients had high blood pressure compared to 38 percent of whites.

Under Control

The National Institute of Neurological Disorders and Stroke and the National Institute on Minority Health and Health Disparities provided funding for the study.

African-American stroke survivor Donald Sisco, age 60, says he went on medication to control his high blood pressure immediately after his stroke four years ago.  Since then, he’s also followed a low-sodium diet.

“We got my blood pressure under control right away,” says the property caretaker from Talbot County, Md.

But many continue to have high blood pressure despite being on medication. 

“Our data don’t reveal the reasons for these differences, though some possible factors to consider are diet, exercise and stress levels,” Kidwell explains.

The study also indicated two social factors that independently predict lower blood pressure – being married or living in a health care facility.

Center of Excellence

Kidwell’s group continues to investigate disparities between races that might account for why blacks are at a higher risk of having strokes.

This summer, Kidwell and two Georgetown colleagues received a $6.1 million grant from the National Institute on Minority Health and Health Disparities to establish the Center of Excellence for Health Disparities in Our Nation’s Capital.

The vision of the Center of Excellence is to dramatically reduce health disparities with a particular focus on minority populations in Washington, D.C.  The program specifically involves disparities in stroke, the 4th leading cause of death in the District, and breast cancer.

Dr. Darin Zahuranec, assistant professor of neurology at the University of Michigan Cardiovascular Center, is first author of the study.

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