Higher Stroke Risk Among Younger Black Adults
MONDAY, March 29, 2021 (American Heart Association News) – Young black adults are almost four times more likely than their white counterparts to have a stroke, according to a new study. Yet regardless of race, the risk of having a stroke at a younger age increased as blood pressure increased.
High blood pressure is the leading cause of stroke. It adds to the workload of the heart and, over time, damages arteries and organs. Experts already knew that stroke rates in young adults had increased over the past few decades, but little was known about the adults most at risk.
The new study, published Monday in the journal Hypertension of the American Heart Association, examined the link between high blood pressure and stroke in a group of young black and white adults in four US cities.
More than 5,000 study participants were repeatedly tested for high blood pressure. Stage 1 hypertension is defined as an upper number of at least 130 or a lower number of at least 80, and stage 2 hypertension is a higher number of 140 or more or a lower number of 90 or more . The upper number (systolic) indicates the pressure exerted by blood on the walls of the arteries while the heart is beating, while the lower number (diastolic) measures the pressure between beats.
During a mean follow-up of 26 years, 100 strokes occurred in participants with and without high blood pressure. But while the overall stroke rate was similar between women and men, it was four times higher in blacks than in whites.
“Four times is a significant and alarming number,” said study co-author Dr. Jamal Rana, chief of cardiology at Kaiser Permanente’s Oakland Medical Center in California. “We know there is more stroke in general in black adults, but we didn’t expect it to be this high. It was striking that the incidence of stroke increased rapidly around the age of 40, especially in black adults.
For all participants, the study found that compared to normal blood pressure, stage 2 hypertension was “strongly and significantly” related to the risk of stroke – more than four times the risk at age 30 and 5.6 times the risk at age 40. and stage 1 hypertension were associated with “more modest increases in risk”.
The findings call for more careful management of blood pressure in young adults, especially black adults, said lead author of the study, Dr Stephen Sidney, director of research clinics and senior researcher in the division. Kaiser Permanente Research Center of Northern California in Oakland.
“The study participants were between the ages of 18 and 30” at the start of the study, he said. “Exposure to blood pressure accumulates over time: your risk increases with the duration of the disease, so it is extremely important to bring hypertension under control as quickly as possible.”
The study was limited by its small size, Sidney said. He and Rana both called for future studies to see how high blood pressure and stroke rates in blacks might be affected by environmental factors, such as lack of access to affordable care, food. healthy and places to exercise.
“The next step is to better understand and address the social determinants that might be contributing to it,” said Rana.
Dr Shawna Nesbitt, who was not involved in the research, called the study a “real call to arms for people to pay attention to stroke prevention and the lower spectrum of blood pressure.”
“We need to let people know that blood pressure is responding to your sodium intake drop and even a small amount of weight loss, like 10 pounds,” said Nesbitt, professor of internal medicine at UT. Southwestern Medical Center and Medical Director of Parkland Hospital. Hypertension clinic in Dallas.
“We also need to remind people how important exercise is for your heart health. During COVID, many people were locked in our homes, watching TV and eating more snacks. We need to aggressively motivate people to start exercising again, or to start exercising if they weren’t already physically active. “
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By Thor Christensen
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