Stroke recovery rates slower for African
Americans
By Margo Warren
Eurekalert, 9 May, 2003
New
research examines reasons for racial disparities
African Americans are more likely to suffer strokes
and recover from them at a slower rate than whites, and these differences
are not simply the result of greater stroke severity. According to Ronnie
D. Horner, Ph.D., program director at the National Institute of
Neurological Disorders and Stroke (NINDS), and leader of a recently
published study, research has found that African Americans who delay their
post-stroke rehabilitation recover at a significantly slower rate than
whites who experience the same rehabilitation delay. Recovery rates are
even lower among low-income African Americans.
Stroke is the third
leading cause of death in the United States, killing 167,000 Americans
each year. African Americans have more strokes at earlier ages, are more
likely to die from them, and experience worse levels of recovery than
other racial groups.
Previous studies
have shown that patients who receive prompt care (within three days of the
stroke) in hospital stroke rehabilitation units, experience lower
mortality and better recovery of physical function.
“We know that
African Americans are more likely to suffer strokes and have worse
outcomes overall. Now we can more closely pinpoint the reasons behind
those negative outcomes and examine ways to make improvements,” said Dr.
Horner, whose research results appear in the April 2003 issue of Stroke.
The study examined
racial differences in timely access to rehabilitation services following a
stroke with patients at nine Veterans Affairs medical centers nationwide.
Patients were treated within the VA health care system, which provides
equal access for its patients, and were followed for one year following
the onset of hemorrhagic or ischemic stroke. The study was funded by
grants from The VA Health Services Research and Development Service and
the VA Cooperative Studies/Epidemiologic Research and Information Center
programs, where Dr. Horner was employed at the time of the research.
“These patients
essentially received the same in-hospital treatment, but the pace of
recovery from stroke was most likely inhibited for blacks due to a lack of
social resources, such as transportation or supplemental in-home care that
can otherwise enhance recovery over time,” said Dr. Horner.
Getting rapid
treatment for an acute stroke can reduce or eliminate the need for
extensive rehabilitation. If given within three hours of initial stroke
symptoms, a clot-busting drug called t-PA can reverse the effects of a
stroke by dissolving blood clots that obstruct blood flow to the brain.
Understanding the signs of a stroke, and getting to a hospital within one
hour after those symptoms appear can significantly reduce disability.
“This study sheds
light on racial disparities in recovery rates from stroke. What is clear
is that we can reduce the numbers of stroke patients who will require
rehabilitation if more patients recognize their symptoms, get to the
hospital and are treated rapidly,” said John R. Marler, M.D., associate
director for clinical trials at NINDS. “The sooner the stroke is
recognized and the patient begins receiving treatment, the better are the
chances for a complete recovery.”
The symptoms of
stroke are distinct because they happen quickly: sudden numbness or
weakness of the face, arm or leg (especially on one side of the body);
sudden confusion, trouble speaking or understanding speech; sudden trouble
seeing in one or both eyes; sudden trouble walking, dizziness or loss of
balance or coordination; or sudden severe headache with no known cause.
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