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Differences in the role of black race and stroke risk factors for first vs. recurrent stroke

George Howard1, Brett M Kissela2, Dawn O Kleindorfer2

  • 1From the Departments of Biostatistics (G.H., L.A.M., S.E.J., J.D.R.) and Epidemiology (V.J.H.), UAB School of Public Health, Birmingham, AL; Department of Neurology (B.M.K., D.O.K.), School of Medicine, University of Cincinnati, OH; Department of Epidemiology (E.Z.S.), Wake Forest University School of Medicine, Winston-Salem, NC; Department of Medicine (M.C.), University of Vermont College of Medicine, Burlington; National Institute of Neurological Disorders and Stroke (C.S.M.), NIH, Bethesda, MD; and Department of Neurology (K.A.S.), UAB School of Medicine, Birmingham, AL. ghoward@uab.edu.

Neurology
|January 22, 2016
PubMed

Insights

Black race significantly increases first stroke risk in younger individuals, but this disparity diminishes with age. This racial difference does not apply to recurrent stroke risk, where risk factors play a similar role for all.

Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Stroke is a leading cause of death and disability worldwide.
  • Understanding disparities in stroke risk is crucial for targeted prevention strategies.
  • Previous research suggests racial and age-related differences in stroke incidence.

Purpose of the Study:

  • To investigate if black race and traditional cerebrovascular risk factors differentially impact first-time stroke events compared to recurrent stroke events.
  • To analyze the interaction between age and race on the risk of first stroke versus recurrent stroke.

Main Methods:

  • A longitudinal cohort study involving 29,682 black and white participants aged 45 years and older.
  • Data collected on demographic factors (age, race, sex) and stroke risk factors (hypertension, diabetes, smoking, atrial fibrillation, etc.).
  • Statistical analysis to estimate the association of these factors with first vs. recurrent stroke over an average 6.8-year follow-up.

Main Results:

  • An age-by-race interaction was observed for first stroke risk: black participants had a significantly higher risk at age 45 compared to white participants, but this disparity disappeared by age 85.
  • No significant racial disparity in the risk of recurrent stroke was found at any age.
  • The association of common stroke risk factors (hypertension, diabetes, etc.) was similar for both first and recurrent stroke events.

Conclusions:

  • The influence of age and black race on stroke risk is distinct for first-time events versus recurrent events.
  • While race plays a significant role in first stroke risk, particularly at younger ages, its impact on recurrent stroke risk is minimal.
  • Traditional stroke risk factors appear to play a comparable role in both first and recurrent stroke.
Abstract

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