Ethnicity as a risk factor for stroke

The risk of stroke varies between different ethnic groups. In many European countries, people from ethnic minorities may face issues of economic deprivation and discrimination. This can impact stroke risk by, for example, reducing access to healthy foods and medical care.

It is difficult to separate out the extent to which stroke risk is due to biological differences between people (race) or their social, economic and cultural situations (ethnicity). 

Do specific populations have a higher stroke risk?

One study in the UK looked at ischaemic stroke risk (caused by a blockage to the brain’s blood supply) for three ethnic populations in south London: black African, black Caribbean and white. The study made adjustments for education, income and type of employment, to avoid them affecting the outcome of the study. These were the key findings1:

  • Black Caribbean people had higher levels of high blood pressure and diabetes but lower levels of atrial fibrillation and smoked less.
  • Black African people had a higher levels of high blood pressure but lower levels of atrial fibrillation, obesity and diabetes.

In the US, the risk of having a first stroke is nearly twice as high for non-Hispanic black adults as for white adults, and non-Hispanic black adults and Pacific Islander adults have the highest rates of death due to stroke2.

For people of south Asian, south-east Asian, black African and black Caribbean descent, the same stroke risk prevention behaviours apply as to the general population3.

Research also shows that the risk of having a second stroke is no higher in the American black population than in the American white population3.

Race/ethnicity and stroke risk: Key points

Stroke risk may depend, in part, on your racial or ethnic background. Strokes tend to occur at younger ages in ethnic minorities and can be more severe4.

According to Levine et al. 2020 “Systemic racism and racial/ethnic injustice produce racial/ethnic disparities in health care and the general health of people. Substantial racial/ethnic disparities in stroke care and health exist and result predominantly from unequal treatment”.

No matter your background, you can be proactive about lowering your risk for stroke.

References

  1. C Hajat, K Tilling, JA Stewart, NL Lemic-Stojcevic, CDA Wolfe. Ethnic differences in cerebrovascular risk factors: a European case-control study. Stroke. 2004. 35:1562–1567. https://doi.org/10.1161/01.STR.0000131903.04708.b8  
  2. Centers for Disease Control and Prevention. 2024. https://www.cdc.gov/stroke/facts.htm
  3. R Mital, J Bayne, F Rodriguez et al. Race and Ethnicity Considerations in Patients With Coronary Artery Disease and Stroke: JACC Focus Seminar 3/9. JACC. 2021 Dec, 78(24):2483–2492.https://doi.org/10.1016/j.jacc.2021.05.051
  4. Deborah A. LevinePamela W. DuncanMai N. Nguyen-Huynh and Olugbenga G. Ogedegbe. Interventions Targeting Racial/Ethnic Disparities in Stroke Prevention and Treatment. Stroke. 2020. 51:3425–3432. https://doi.org/10.1161/STROKEAHA.120.030427    
  5. G Howard, BM Kissela, DO Kleindorfer, LA McClure, EZ Soliman, SE Judd, JD Rhodes, M Cushman, CS Moy, KA Sands, VJ Howard. Differences in the role of black race and stroke risk factors for first vs. recurrent stroke. Neurology. 2016. 86:637–642. https://doi.org/10.1212/WNL.0000000000002376

STROKE RISKS

Read about risk factors we can change 

LIFESTYLE

ENVIRONMENT

MEDICAL
CONDITIONS

Read about risk factors we cannot change 

AGE

BIOLOGICAL
SEX

ETHNICITY

GENETICS

MEDICAL
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