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Stroke in young black patients. Risk factors, subtypes, and prognosis
A I Qureshi1, K Safdar, M Patel
1Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Insights
Young Black patients experience a high rate of stroke, often linked to hypertension and resulting in severe outcomes like hypertensive intracerebral hemorrhage and lacunar infarction, indicating accelerated vascular damage.
Area of Science:
- Neurology
- Vascular Medicine
- Public Health
Background:
- Stroke presentation and outcomes vary by race and age.
- Limited data exist on stroke in young Black populations.
Purpose of the Study:
- Investigate stroke risk factors, subtypes, and prognosis in young Black patients.
- Compare stroke characteristics in young Black patients to other demographics.
Main Methods:
- Retrospective review of medical records for patients aged 15-44 admitted with stroke.
- Data collected from January 1990 to June 1994 at a university-affiliated public hospital.
Main Results:
- Hypertension was significantly more common in young Black stroke patients (55%) than non-Black patients (24%).
- Hypertensive intracerebral hemorrhage (64%) and lacunar infarction (21%) were the predominant stroke subtypes in young Black patients.
- Outcomes at discharge for young Black patients included 69% independent, 8% dependent, and 23% deceased.
Conclusions:
- High incidence of hypertension and specific stroke subtypes suggest accelerated hypertensive arteriolar damage in young Black individuals.
- Poor hypertension control may be a contributing factor to severe stroke in this demographic.
- Findings highlight the need for targeted stroke prevention and management strategies for young Black populations.
Background And Purpose:
Stroke subtypes and prognosis differ among older black patients compared with whites; however, few data are available regarding stroke among young black patients.
Methods:
To determine the risk factors for stroke, stroke subtype, and prognosis among young black patients, we retrospectively reviewed the medical records of all 15- to 44-year-old patients admitted with stroke to a university-affiliated public hospital from January 1990 through June 1994.
Results:
Of the 248 eligible patients admitted with stroke, 219 were blacks. Hypertension was more frequently associated with stroke in young black than in non-black patients (55% versus 24%, P = .003). Cocaine abuse was frequent among both black and non-black patients (27% versus 38%, P = NS). Hypertensive intracerebral hemorrhage (64%) was the most common subtype of intracerebral hemorrhage (n = 67), and lacunar infarction (21%) was the most common subtype of cerebral infarction (n = 112) in young black patients. Outcome in black patients with stroke at discharge was 69% independent, 8% dependent, and 23% dead.
Conclusions:
The high frequency of hypertension, hypertensive intracerebral hemorrhage, and lacunar infarction among young black patients with stroke suggests accelerated hypertensive arteriolar damage, possibly due to poor control of hypertension.