Abstract WP206: A Tale of Blacks With Stroke on Two Continents and in Two Eras

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Abstract

Background: It is projected that Sub-Saharan Africa (SSA) will experience a rising epidemic of cardiovascular diseases (CVD) driven by a surge in rates of major CVD risk factors; while it has been well established for several decades that African Americans have a much higher stroke incidence and mortality than their non-Hispanic White Counterparts.

Objective: To compare baseline characteristics of current Black stroke survivors in SSA with Black stroke survivors encountered during a roughly similar epidemiologic stage (i.e. earlier aspects of the “Age of Degenerative and Man-Made Diseases”) in the United States (US).

Methods: We compared baseline data obtained in 1960 from stroke cases within the historical Black Pooling Project (BPP) comprising the Charleston Heart Study and Evans County Heart Study cohorts with baseline data from stroke cases encountered within the ongoing Stroke Investigative Research and Education Network (SIREN) Project taking place at several sites in Nigeria and Ghana.

Results: There were 188 stroke cases in the BPP cohort and 422 in the SIREN cohort. We found a similar pattern of events by age (figure 1) between the two study populations with the majority of the strokes occurring before 65 years of age (BPP 67%;SIREN 65%). However, SIREN cases were more common at the age extremes, and BPP cases more common in the middle-age range. Modifiable risk factors were comparable between the groups: hypertension (BPP 89%; SIREN 90%) and diabetes (BPP 3%; SIREN 20%).

Conclusion: While baseline hypertension rates of Black American stroke survivors in the 1960s and Black Africans in the 2010s are similar, the former experienced stroke more frequently in mid-life and lower rates of diabetes. Further phenotypic and genotypic comparisons of both these cohorts could provide novel insights into stroke risk among people of African ancestry.

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