Ethnic inequalities in stroke explained by differences in stroke risk factors
Stroke risk is primarily linked to differences in traditional stroke risk factors, like diabetes and high blood pressure, rather than ethnicity, according to findings from a new south London study conducted at King's College London.
A recent study from King's College London has shed light on the ethnic inequalities in stroke incidence. While previous research has shown that Black and Asian individuals have higher rates of stroke compared to white individuals, and hypertension and diabetes are identified as significant contributors to these disparities, the exact role of ethnicity in stroke risk has been debated.
To investigate this further, researchers analyzed electronic health records from over 650,000 people in south London collected between 2005 and 2021. The study focused on three major stroke risk factors: hypertension, diabetes, and hypercholesterolemia (high cholesterol). The researchers used a modeling technique called multistate analysis to examine how individuals move through different health states over time, from having no risk factors to developing one or more risk factors and ultimately having a stroke.
The results showed that while Asian and Black individuals were more likely to have hypertension and diabetes compared to white individuals, the probability of stroke did not differ significantly between these ethnic groups once they already had these conditions. In other words, Black and Asian patients with hypertension or diabetes were not at a higher risk of having a stroke than white patients with the same conditions.
The findings suggest that ethnic inequalities in stroke risk are primarily driven by these cardiometabolic risk factors. Dr. Marc Delord, a research fellow at King's College London, emphasized that reducing stroke disparities requires addressing the underlying inequalities in prevention, early detection, and management of hypertension and diabetes, particularly in Black and Asian communities.
The study also found that while Black patients with high cholesterol had a slightly increased risk of stroke compared to white patients, further investigation is needed to determine if this disparity is related to differences in statin treatment.
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