RACIAL DISPARITIES IN STROKE AFFECTING BLACK AMERICANS.

Abstract

Stroke is the fifth leading cause of death in the United States and disproportionately affects Black Americans. The Reasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort study is investigating why this disparity exists by comparing Black and White adults age 45+. Seminal findings included that higher stroke incidence in Black than in White persons, but not higher case fatality, drives the disparity. Higher prevalence of stroke risk factors in Black participants, especially hypertension and diabetes, explained 50% of the racial disparity. Elevated lipoprotein(a) was three times more frequent in Black participants and was a race-specific stroke risk factor only among Black participants. Higher interleukin-6 was a strong stroke risk factor in both Black and White participants with a hazard ratio of 2.0 for concentrations in the top versus bottom quartile. In mediation analysis, higher interleukin-6 with presence of stroke risk factors party explained the race disparity in stroke. Findings highlight the potential that prevention of stroke risk factors, treatment of higher Lp(a), and inflammation reduction have in reducing the race disparity in stroke.