SECULAR TRENDS IN STROKE MORTALITY IN AFRICAN-AMERICANS - THE ROLE OFURBANIZATION, DIABETES AND OBESITY

The decline in stroke mortality rates in African Americans has slowed to that seen in the 1960s; rates remain higher than in European Americ ans. Rates are higher in the southeastern US and in nonmetropolitan ar eas. Adverse trends and patterns in diabetes, obesity, and heart disea se prevalence are possible explanations. Unless new, effective prevent ion programs are introduced in African American communities, stroke mo rtality rates will decline slowly if at all. The best chance to increa se the rate of decline in stroke mortality rates in African Americans may be to redouble efforts to achieve the goals for the year 2000. Com munity and patient education on improving diet, increasing exercise, f urther improving detection and control of hypertension, using aspirin in stroke prevention and active control of stroke risk factors in diab etics must be stressed.