Stroke mortality in blacks - Disturbing trends

Background-Despite long-term declines in US stroke mortality rates, decline s have slowed in the past decade and targets for blacks for the years 2000 and 2010 seem attainable only by extraordinary measures, if at all. This re view focuses attention on key aspects of this problem. Data from the US Nat ional Center for Health Statistics and reports of population-based studies of stroke mortality published since 1987 retrieved by computerized literatu re searches were reviewed. Summary of Review-The third leading cause of death in black women and the s ixth in black men in the United States in 1996, stroke accounted for 10 509 deaths in women and 7972 in men among blacks: 7.92% and 5.33%, respectivel y, of the total deaths. Age-adjusted death rates per 100 000 were black wom en, 39.2; white women, 22.9; black men, 50.9; and white men, 26.3. Availabl e data indicate that compared with US whites, US blacks have greater mortal ity rates for every stroke subtype, with the likely exception of cerebral i nfarction due to extracranial carotid artery occlusion. These differences w ill persist into the 21st century. The number of stroke deaths in blacks in creased by >8% between 1992 and 1996. Conclusions-Increased research on stroke in blacks is needed to develop mor e effective strategies for primary and secondary prevention of stroke to re duce the high burden of premature mortality and morbidity. Renewed efforts to prevent and control stroke risk factors tin particular elevated blood pr essure, diabetes, and smoking) are needed among US blacks.