Racial disparity in stroke risk factors: the Berlin-Ibadan experience; a retrospective study

Abstract

The risk factors associated with cerebral infarction were more frequent in Berlin. We suspect that racial disparity in risk factors for stroke may account for the difference in proportions of stroke subtype in black and white populations. Larger prospective community-based multinational multiracial studies are required to confirm these disparities and identify possible underlying genetic, dietary, and socio-economic factors.

A prospective study of stroke sub-type from within an incident population in Tanzania

“…2,5,[25][26] In our study, although hypertension was found in 48.1% of cases in Hai and 60.7% in Dares-Salaam, it was not significantly associated with a higher incidence of cerebral haemorrhage. Studies of the general population have indicated an age-standardised rate of hypertension in the Hai DSS of 13.1% in men and 13.3% in women, and in the Dar-es-Salaam DSS of 18.5% in men and 22.0% in women using a cut off of >160/90 mmHg, indicating higher levels of hypertension in those who have had a stroke than in the general population.…”

“…The percentage of strokes due to cerebral haemorrhage and the mean age of participants were similar to studies in high-income countries. 2,5,14,21 Participants were much older than in previous studies from SSA. 2,5,6,9 In a resource-poor setting younger people may be more likely to be taken to hospital.…”

“…[31][32] In Hai 73.3% and in Dar-es-Salaam 73.8% of participants were hypertensive (cut-off ≥140/90 mmHg), compared with 99% of hypertensive stroke patients using the same cut-off in Ibadan, Nigeria. 5 Although not statistically significant, the Hai cohort had lower rates of hypertension than the Dar-es-Salaam cohort. This may in part be due to the relatively good coverage of primary health care services in Hai compared with SSA as a whole, 27 which in turn may account for the fact that over 60% of those with hypertension in the Hai DSS had had their blood pressure monitored in the 12 months before interview, compared with less than 30% in Dar-es-Salaam.…”

“…[25][26][29][30] Nevertheless, Owolabi et al 5 suggested that even when comparing cohorts of urban black Africans and urban Caucasian Europeans the incidence of stroke due to cerebral haemorrhage, and associated risk factors, is still higher in Africans. Urban dwellers from Africa have a higher incidence of hypertension than those from rural communities, with a rise in blood pressure seen on migration from the countryside to cities.…”

Sickle Cell Trait Appears to Increase the Risk of Hemorrhagic Stroke in African Adults with Dyslipidaemia: A Pilot Study

“…In this type of stroke, the primary pathology is an area of bleeding causing direct damage to the brain tissue. I hospital based studies, It constitutes up to 37.0%-40.9% of all strokes in Nigeria [2,3] with a significantly higher morbidity and mortality compared with ischaemic stroke. A 10-fold increase in the risk of haemorrhagic stroke has been observed in individuals with HbAS [4].…”