The Risk of Stroke Doubles in Black Patients: Strategies for Prevention by Doctors

• Stroke is the fifth leading cause of death in the United States, but it is preventable.
• Black people are twice as likely to have a stroke compared to other racial groups.
• New research suggests that attentive medical care can eliminate disparities and prevent stroke.

Having a competent doctor can transform a visit to the doctor’s office from dreadful to tolerable, and perhaps even enjoyable. Attentive care can also contribute to long-term health improvement, including reducing the risk of stroke.

Stroke ranks as the fifth leading cause of death in the United States, affecting over 795,000 people annually. Black adults are twice as likely as white adults to experience a stroke, and Black individuals have the highest death rate from stroke compared to other racial groups, according to the CDC.

The issue at hand is complex. Systemic racism impacts the health of Black Americans through various channels, from limited access to nutritious food to subpar medical care as highlighted by a group of prominent doctors in an editorial published in JAMA.

However, there are concrete steps that doctors can take to reduce the risk of stroke, as revealed by a recent study published on August 3 in the journal Stroke.

“There is a significant disparity in the healthcare system as a whole,” stated Dr. Eyad Almallouhi, a neurointerventionalist at Sarasota Memorial Hospital in Sarasota, Florida, and one of the lead authors of the study, in an interview with Insider. “So, it is crucial to understand how we can minimize this disparity.”

The researchers compared the outcomes of Black patients and non-Black patients who participated in a study conducted between 2008 and 2011. They discovered that attentive medical care not only reduced disparities but also prevented future strokes.

Here are three key measures that doctors should adopt, according to Dr. Eyad Almallouhi and Dr. Ashley Nelson, co-authors of the study and neurology residents at the Medical University of South Carolina in Charleston.

Develop a personalized exercise and diet regimen that patients can adhere to

A stroke occurs when blood flow to a part of the brain is interrupted, resulting in a lack of oxygen. Strokes can be fatal or lead to permanent disability.

Patients in the study received “intensive lifestyle modification coaching, medication management, and regular follow-up access,” collectively known as “medical management.” The original study revealed that medical management proved more effective than the use of a stent, a medical device that opens narrowed arteries, in preventing future strokes.

At the beginning of the study, Black patients were less physically active than non-Black patients and had a higher prevalence of type 2 diabetes, high cholesterol, and hypertension—all risk factors for stroke.

However, after one year of medical management, the situation changed, and significant stroke risk disparities between Black patients and other patients had largely disappeared. In particular, medical management eliminated differences in patients’ diastolic blood pressure, a prominent marker of cardiovascular health, and significantly increased physical activity.

Ultimately, the researchers concluded that medical management also eliminated disparities in future stroke or death rates for Black patients.

Increase the frequency of follow-up visits for Black patients at risk of stroke

Almallouhi mentioned that the study’s “helpful” feature was the “close follow-ups with patients to properly monitor and ensure effective control of their risk factors.”

Throughout the study, patients received more frequent check-ups compared to the average American, as documented in CDC data, which included five doctor’s visits within a year. These visits included the initial consultation, along with follow-up visits at 30 days, four months, eight months, and twelve months.

The increased frequency of visits allowed doctors to assess the effectiveness of each patient’s treatment plan. If a patient’s blood pressure remained high during a follow-up visit, for example, doctors could adjust the medication to help bring it within a healthy range. They also provided lifestyle coaching to assist patients in improving their physical fitness.

Foster a trustworthy environment

Almallouhi pointed out that Black patients often encounter more obstacles in accessing medical care compared to white patients, resulting in disparities in health outcomes.

However, trust is also a critical factor. In 2020, the American Heart Association (AHA) issued a “Follow Google News