Abstract HUP16: Exploring Differences in Stroke Type and Stroke Risk Factors Between Young African Americans and Ghanaian Stroke Women

Abstract

Introduction: Recent reports demonstrate that stroke prevalence is expanding in young women, especially in diverse populations. Our goal was to compare the stroke type and stroke risk factors among patients with African Ancestral lineage, including African Americans (AA), West African (WA) descent from Ghana, a country in West Africa, and those without African Ancestral (WAA) lineage. Methods: Women aged 18- 45 from our institutional stroke databases and the Kumasi, Ghana Stroke Survivors Registry between January 2014 and November 2019 were included in this retrospective study. Non-parametric t-test and chi-square analysis was used for statistical analysis to identify significant differences between stroke type and stroke risk factors. Results: Among the 236 subjects, the median age was similar between groups (p-value 0.3940) [40 (IQR 35-43) Ghana, n= 91; 43 (IQR 34-43) in AA, n= 43, and 39 (IQR 31-43) WAA, n= 102). In the total population, 25% had an intracerebral hemorrhage, 56% had an ischemic stroke, and 19% had a subarachnoid hemorrhage. The proportion of patients with ischemic stroke was similar between groups (p-value 0.20). However, the frequency of subarachnoid hemorrhages was the lowest in the WA cohort (9%) in comparison to AA (33%) and those WAA lineage (22%), p-value 0.017. The incidence of intracerebral hemorrhage was lowest in those WAA lineage (15%) versus the AA cohort (33%) and the WA cohort (34%) p-value 0.0358. Prevalence of hypertension was highest in Ghanaians (87%) vs 60% AA, and 34% in those WAA lineage, p-value 0.0008. Patients from Ghana were less likely to smoke (1%) versus AA cohort (36%), and those WAA (31%) lineage, p-value 0.0001. Conclusion: Significant differences were found between stroke type and risk factors in young women with stroke (hypertension, DM, and smoking), race, and country of origin. These findings are important because behavioral interventions reducing smoking and controlling blood pressure are effective for the prevention of subarachnoid and intracerebral hemorrhage. Studying social and environmental influential factors between groups may identify points of intervention to reduce stroke in AA and West African young women.