The risk of stroke and death from stroke are generally higher in black people than whites in the United Kingdom and the United States. In south London, where this study took place, the average age of people with stroke is 10 years lower than in the whole population.

The study involved over 2,000 patients registered on the south London stroke register after having a first stroke between 1995 and 2002. Data on ethnicity, socioeconomic class, and treatment of existing health problems were collected and survival was calculated.

Despite an increased risk of stroke, black patients were more likely to survive than white patients. The results showed a clear survival advantage, with five year survival being 57% for black people and 36% for white people. This trend remained after adjusting for several factors that may have affected the results, such as age and socioeconomic status.

Older black people in particular (75 and over) had a substantial survival advantage over similar white people. Current smoking, untreated atrial fibrillation (irregular heart rhythm) and diabetes, treated or untreated, were all associated with worse survival.

It seems that black people have better access to stroke unit care and more active management of some modifiable risk factors before stroke, say the authors.

They suggest that more detailed measures of socioeconomic status, education, and care after stroke need to be incorporated into future studies to identify the contribution of such factors on survival.

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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
28-Jul-2005