Racial differences for lacunar infarcts documented by computed tomography: A comparison of black and white patients

Lacunar stroke in 100 black and 30 white patients with lacunar syndrome and computed tomography (CT) positive for lacunar infarct were compared. Of blacks, 88% were hypertensive, 77% had target-organ damage, and 86% were hypertensive for longer than 8 years. Of whites, 60% were hypertensive, 61% had target-organ damage, and 72% were hypertensive for longer than 8 years. Prior clinical stroke occurred in 7% of blacks and 50% of whites. Transient ischemic attacks (TIAs) were found in 33% of blacks and 53% of whites. In blacks, CT showed single lacunes in 57% and multiple lacunes in 43%. In whites, CT showed single lacunes in 64% and multiple lacunes in 36%. Angiography was abnormal in 22% of blacks and 54% of whites. In blacks, lacunar stroke was associated with hypertension in 88%, and lacunar stroke was the initial cerebrovascular manifestation in 80%; CT showed "silent" lacune(s) in 41% of hypertensive blacks. In whites, lacunar stroke was associated with hypertension in 60%, and 6% had "silent" lacunes. Based on CT findings, only hypertensive patients had "silent" lacunes.