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African Americans recover from strokes at a slower rate than whites

African Americans are more likely to suffer strokes and recover from them at a slower rate than whites, and these differences are not simply the result of greater stroke severity. According to Ronnie D. Horner, Ph.D., program director at the National Institute of Neurological Disorders and Stroke (NINDS), and leader of a recently published study, research has found that African Americans who delay their post-stroke rehabilitation recover at a significantly slower rate than whites who experience the same rehabilitation delay. Recovery rates are even lower among low-income African Americans.

Stroke is the third leading cause of death in the United States, killing 167,000 Americans each year. African Americans have more strokes at earlier ages, are more likely to die from them, and experience worse levels of recovery than other racial groups.

Previous studies have shown that patients who receive prompt care (within three days of the stroke) in hospital stroke rehabilitation units, experience lower mortality and better recovery of physical function.

“We know that African Americans are more likely to suffer strokes and have worse outcomes overall. Now we can more closely pinpoint the reasons behind those negative outcomes and examine ways to make improvements,” said Dr. Horner, whose research results appear in the April 2003 issue of Stroke.

The study examined racial differences in timely access to rehabilitation services following a stroke with patients at nine Veterans Affairs medical centers nationwide. Patients were treated within the VA health care system, which provides equal access for its patients, and were followed for one year following the onset of hemorrhagic or ischemic stroke. The study was funded by grants from The VA Health Services Research and Development Service and the VA Cooperative Studies/Epidemiologic Research and Information Center programs, where Dr. Horner was employed at the time of the research.

“These patients essentially received the same in-hospital treatment, but the pace of recovery from stroke was most likely inhibited for blacks due to a lack of social resources, such as transportation or supplemental in-home care that can otherwise enhance recovery over time,” said Dr. Horner.

Getting rapid treatment for an acute stroke can reduce or eliminate the need for extensive rehabilitation. If given within three hours of initial stroke symptoms, a clot-busting drug called t-PA can reverse the effects of a stroke by dissolving blood clots that obstruct blood flow to the brain. Understanding the signs of a stroke, and getting to a hospital within one hour after those symptoms appear can significantly reduce disability.

“This study sheds light on racial disparities in recovery rates from stroke. What is clear is that we can reduce the numbers of stroke patients who will require rehabilitation if more patients recognize their symptoms, get to the hospital and are treated rapidly,” said John R. Marler, M.D., associate director for clinical trials at NINDS. “The sooner the stroke is recognized and the patient begins receiving treatment, the better are the chances for a complete recovery.”

The symptoms of stroke are distinct because they happen quickly: sudden numbness or weakness of the face, arm or leg (especially on one side of the body); sudden confusion, trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness or loss of balance or coordination; or sudden severe headache with no known cause.


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