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African Americans and stroke risk

By Louis Neipris, M.D., Staff Writer, myOptumHealth

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A stroke can happen to anyone at any time. But it’s more likely to happen if you’re African American. Compared to Caucasians, African Americans:

  • Have nearly double the risk of a first stroke
  • Are twice as likely to die of stroke
  • Are more likely to be disabled due to stroke
  • Are more likely to have a stroke early in life (age 20 to 44)
  • Are less likely to receive clot-busting drugs (like TPA)

Why is the risk greater in African Americans?

There is no clear reason why stroke is more common in African Americans. But it is clear that risk factors play a role. African Americans have a higher rate of:

  • Overweight/obesity
  • Smoking
  • Diabetes
  • High cholesterol

These are all risks for stroke.

What exactly are stroke risks?

A stroke risk factor is a condition or habit that raises your risk of having a stroke. Some risks are beyond your control. These include your age, having a family history of stroke or a previous history of stroke or TIA (mini-stroke). But other risks you can change.

Lifestyle risks you can reduce are:

  • Smoking
  • Obesity
  • Heavy alcohol use
  • Medical risks you can reduce with your doctor’s help are:
    • High blood pressure, which makes the heart work harder to move blood. Blood vessel walls in the brain can weaken and lead to stroke.

    • High cholesterol, which raises the risk of heart disease, as well as stroke. Cholesterol is a fatty substance that comes from fat in foods, like red meat. It can build up on artery walls (as plaque) and reduce blood flow. A blood clot can block blood flow through a narrow artery and lead to a stroke or heart attack.

    • Diabetes, which affects more than million African Americans, raises stroke risk four times compared to those without the disease. This is mainly because many people with diabetes have heart disease, high blood pressure and other stroke risk factors. If you have diabetes, keep your blood sugar under control and reduce your other stroke risks.

    • Atrial fibrillation, a type of irregular heart rhythm. Atrial fibrillation raises the risk of stroke because the blood tends to pool in the heart, which can lead to the formation of a blood clot. A piece of the blood clot can break off and get carried to the brain, causing a stroke.

    • Sickle cell anemia, in which red blood cells are abnormally shaped and can block blood vessels. Sickle-shaped cells can block a blood vessel in the brain and cause a stroke. Sickle cell disease is more common in African Americans.

How can I reduce risks?

You can lower your risk of stroke considerably. And in doing so, you also cut your risk of other conditions, like heart disease and diabetes. Here’s what you can do:

1) Have your blood pressure checked as often as your doctor suggests. The most important risk factor for stroke is high blood pressure. It’s called the “silent killer” because there are no symptoms. About one in three African Americans (both men and women) has high blood pressure. If you have high blood pressure, you may need to take medicine to keep your blood pressure under control.

2) Know your cholesterol numbers. Ask your doctor about a cholesterol blood test. If your cholesterol numbers are borderline or high risk, work with your doctor to lower your risk of heart disease and stroke.

3) Eat right to reduce stroke risk. Just keep a few points in mind:

  • Reduce sodium (salt). Avoid canned foods, where sodium content is often high. Avoid lunch meats that are high in sodium.

  • Reduce cholesterol. Go for lean meats, such as chicken and fish. Trim skin and fat from chicken.

  • Reduce your calories. This is important if you are trying to reach a healthy weight. Limit portion sizes. Look at the calorie amounts of foods by reading the label.

  • Increase fiber. Go for high-fiber foods, such as whole-grain breads. Have beans, a great source of lean protein as well as fiber.

  • Have plenty of fruits and vegetables.

  • Don’t fry. Instead, prepare foods by baking, broiling and steaming.

4) Quit smoking if you smoke. Smoking not only raises your risk for heart attack and lung cancer. It also doubles your risk for stroke. Get smoking cessation advice from your doctor. Remember, your stroke risk starts to drop the moment you quit.

5) Be active – exercise! Chose an activity you enjoy that keeps up your heart rate, like jogging, cycling or even taking a brisk walk. Regular exercise helps you to reach and maintain a healthy weight. Adults should do moderate to intense exercise for at least 30 minutes on most days of the week. Talk to your doctor before you start to exercise or ramp up your exercise routine.

6) If you drink alcohol, drink only in moderation. Drinking an average of more than one alcohol-containing drink a day (for women) or more than two drinks a day (for men) raises blood pressure, which is a stroke risk. Drinks with alcohol, especially beer, are also a source of empty (non-nutritional) calories, which can lead to overweight/obesity.

View the original African Americans and stroke risk article on myOptumHealth.com 


  • National Stroke Association. African Americans and stroke. Accessed: 04/10/2010
  • U.S. Department of Health and Human Services. Office of Minority Health. Stroke and African Americans. Accessed: 04/10/2010
  • American Stroke Association. Stroke information: African Americans and stroke. Accessed: 04/10/2010
  • National Stroke Association. Stroke and African Americans. Accessed: 04/10/2010


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