|
|
|
May 2006 – Stroke and African-Americans
African-Americans Face a Higher Risk for StrokeStroke is the third leading cause of death and the No. 1 cause of disability in this country.
Each year, about 700,000 Americans suffer a new or recurrent stroke.
And in this country, African-Americans are affected by stroke more frequently than any other group.
“Compared to Caucasians, African-Americans have twice the risk of having a first-time stroke, and they have a higher death rate from stroke,” said Ann Helms, MD, Froedtert & the Medical College of Wisconsin neurologist.
A stroke occurs when a blood vessel in the brain bursts or is blocked by a clot. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so the brain tissue starts to die.
“Stroke is very abrupt,” Dr. Helms said. “Two million brain cells die each minute. In a short time, this can result in significant neurological damage.”
The effects of a stroke depend on many factors including the location in the brain and how much brain tissue has been affected. A stroke may cause paralysis, difficulty talking or understanding speech, vision problems, behavioral changes, memory loss — or death.
“Most people don’t die from a stroke,” Dr. Helms said, “but they are left with disability that may be permanent. With immediate medical care and rehabilitation, some people may recover or have only mild impairments.”
Stroke is a very complex disease and many factors can contribute to a stroke. “In African-Americans, the likelihood of certain types of strokes and certain causes of stroke are higher than in Caucasians. This seems, in part, to be related to genetics,” Dr. Helms said. “For instance, the bleeding type of stroke (caused by a burst blood vessel) is more frequent among African-Americans because they have a genetically higher risk for high blood pressure.”
In general, however, a stroke caused by a clot is the most common type of stroke in all patient groups. The leading cause is a significant narrowing or blockage of the carotid arteries caused by a buildup of plaque in the artery walls. The carotid arteries are the main blood supply to the brain. In African-Americans, however, a larger percentage of patients will have a buildup of plaque in the arteries inside the brain, rather than in the neck vessels.
Risk FactorsAccording to Dr. Helms, the higher risk for stroke among African-Americans is related to a combination of genetics, lifestyle factors and access to health care. “African-Americans have higher rates for many of the risk factors for stroke, and the risk factors develop at a younger age,” she said. “We see strokes in African-Americans in their 20s, 30s and 40s more often than in other groups.”
In addition to high blood pressure, risk factors include smoking, diabetes, high cholesterol, obesity and metabolic syndrome (a specific group of metabolic risk factors that appear in a person). African-Americans have higher risks for:
- High blood pressure, the major risk factor for stroke; one in three African-Americans has high blood pressure
- Diabetes, which contributes to a higher stroke risk; African-Americans are almost twice as likely to have diabetes as Caucasians
- Obesity and smoking. African-Americans have a higher incidence of these two risk factors
- Sickle cell anemia, a disease that primarily affects black Africans and African-Americans; if sickle-shaped cells block a blood vessel to the brain, a stroke can result
Stroke SymptomsAny abrupt change in the way a person functions could be a stroke. Yet, most people don’t recognize that their symptoms were caused by a stroke.
“Because stroke is painless, a person may wait before seeking medical help in the hope that their symptoms will subside,” Dr. Helms said. “But this is devastating. Stroke is a medical emergency, and a person needs to get immediate medical care – within a few hours.”
Brain damage occurs rapidly following a stroke. This short window of time makes it very important to recognize the symptoms of a stroke:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
Recognize the warning signs, and call 911 immediately if you or someone close to you has any of these symptoms.
Mini-strokesSome people experience a transient ischemic attack (TIA), also called a “mini-stroke.” TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. The symptoms of a TIA are the same as those of stroke — only temporary — and most TIAs last less than five minutes.
Unlike stroke, when a TIA is over, there’s no injury to the brain. Once a TIA has occurred, however, the person is at high risk for another stroke within 48 hours. Therefore, a TIA should never be ignored. If you think you had a mini-stroke, you should seek immediate medical care to prevent a more serious stroke from occurring. Call 911 right away.
Stroke is Preventable!African-Americans and others can reduce their risk for a stroke by talking to their doctor about their risk factors and being screened (tested) early for them. Then, follow the doctor’s plan of care to lower your risks, and continue annual screenings.
If you smoke, quit. Quitting smoking will reduce a person’s risk by 50 percent in the first year. If you have diabetes, high blood pressure or high cholesterol, take prescribed medications and follow your doctor’s advice to lower these risks.
Because African-Americans are more susceptible to all forms of stroke, doctors should screen their African-American patients earlier for stroke risk factors and should pay special attention to disease of the smaller blood vessels, in addition to standard carotid artery screening for stroke.
Stroke and Neurovascular Program Effective and safe treatment of stroke requires immediate and expert emergency medical attention. The Stroke and Neurovascular Program at Froedtert & the Medical College of Wisconsin is the only one of its kind in eastern Wisconsin to provide comprehensive care for stroke patients.
The program’s Acute Stroke Team (FAST) is prepared 24 hours a day, seven days a week to provide stroke patients with rapid access to expert diagnosis and treatment. Dedicated stroke specialists have the training and expertise to safely administer the latest stroke therapies to dissolve or remove stroke-causing clots, as well as surgical treatment for stroke. Team members include critical care neurologists, neurosurgeons, interventional neuroradiologists, emergency medicine physicians and nurse specialists. And the dedicated stroke inpatient unit is staffed by nurses who are specially trained to care for stroke patients.
Rehabilitation is another important part of recovery. The program’s stroke and neurovascular rehabilitation team provides physical therapy, speech therapy, occupational therapy and psychological assessment. The comprehensive rehabilitation process includes access to support groups to help patients and their families adjust to the changes in their day-to-day lives.
Stroke FactsAccording to the American Stroke Association (ASA), stroke death rates (2003) per 100,000 population was 51.9 for Caucasian males, 50.5 for Caucasian females, 78.8 for African-American males and 69.1 for African-American females. During American Stroke Month, the ASA has launched a Power to End Stroke campaign to encourage African-Americans to:
- Put down cigarettes and stop smoking
- Observe advice from your doctor and learn your family history
- Watch your weight and be physically active at least 30 minutes on most days
- Eat healthfully, and avoid foods high in saturated and trans fats, cholesterol and sodium
- Regulate high blood pressure and diabetes
Author: Marla Fraunfelder Date: May 8, 2006 Online Editor(s): Christopher Sadler
|