Stroke hospitalizations among middle-aged blacks are increasing in South Carolina - highlighting the need for intervention among younger, high-risk groups, according to new research published in the American Heart Association journal Stroke.
Stroke, the No. 4 killer and a primary cause of long-term disability in the United States, affects more blacks than whites and is more prevalent in the southeastern regions known as the "Stroke Belt."
Within the "Stroke Belt," the three "Stroke Buckle" states - South Carolina, North Carolina and Georgia - have the highest rates of stroke and related death.
"Excess strokes among blacks as well as the lingering racial disparity in the younger groups represent a serious public health issue," said Wayne Feng, M.D., M.S., the study's lead author and assistant professor and stroke neurologist at the Medical University of South Carolina Stroke Center in Charleston. "This issue is not limited to the stroke belt as similar data has also been noted elsewhere."
Researchers analyzed records for 84,179 stroke patients discharged from hospitals in South Carolina in 2001-10 and found:
- Stroke hospitalizations among blacks younger than 65 increased by more than 17 percent.
- Stroke hospitalizations among whites younger than 65 remained the same.
- Slightly more than half of black patients hospitalized were younger than age 65, compared to 30 percent of whites.
- Of $2.77 billion in hospital charges, $453.2 million (16.4 percent) were associated with racial disparity (79.6 percent from patients younger than 65)
- Stroke hospitalizations decreased in blacks and whites 65 years and older.
- The 30-day death rate from stroke steadily decreased among all age and racial groups.
"Our results show the importance of staying healthy, exercising and eating well, and starting these healthy habits while you are still young," Feng said. "Combined with annual physician checkups to identify and treat diseases, such as high blood pressure, high cholesterol and diabetes, at an early stage, these habits can help you prevent stroke down the road."
The higher prevalence of stroke risk factors, including hypertension, diabetes, dyslipidemia and smoking, is perhaps the most important contributing factors for excess strokes among young/middle-aged blacks.
Young and middle-age stroke survivors are frequently left with significant disability that persists during their peak years of productivity - ultimately "placing an undue, both direct and indirect, burden to family as well as to society," researchers said.
Stroke occurs when a blood vessel in the brain either becomes blocked by a clot or ruptures, resulting in decreased blood and oxygen flow to brain cells. While risk increases with advanced age, stroke can occur at any age.
Co-authors are Andrea D. Boan, Ph.D., M.S.C.R.; Bruce Ovbiagele M.D., M.Sc.; David L. Bachman, M.D.; Charles Ellis, Ph.D.; Robert J. Adams, M.D., M.S.; Steven A. Kautz, Ph.D.; and Daniel T. Lackland, Dr. PH. Author disclosures are on the manuscript.
The study was funded by Southeastern Virtual Institute for Heath Equality and Wellness; U.S. Army Medical Research and Material Command and Telemedicine & Advanced Technology Research Center; Stroke Education and Prevention - South Carolina, Health Sciences South Carolina; and the Consortium for Southeastern Hypertension Control.