Risk factors for stroke in blacks: A critical review

Stroke is the third leading cause of death in US Blacks and is an important cause of mortality and morbidity worldwide. Mortality rates are higher in Blacks than in Whites in the United States at ages below 70 years. In Black s, advanced age, elevated blood pressure, diabetes mellitus, and smoking ar e the only risk factors for stroke whose status has been firmly established by published data. More data are needed to assess other likely risk factor s of importance for risk stratification and intervention and to determine t he fraction of racial differences in stroke that may be explained by risk f actor differences. Higher prevalences of hypertension, diabetes, obesity (i n women), elevated lipoprotein(a) level, smoking (in men), and low socioeco nomic status may contribute to the higher stroke incidence and mortality in US Blacks as compared with Whites. However, further environmental influenc es must be studied and candidate genes identified before assuming that raci al differences can be attributed to inborn susceptibility linked to inherit ance of specific genes.