Abstract

Stroke is one of the leading causes of disability and death worldwide and places a significant burden on healthcare systems. There are significant racial/ethnic differences in the incidence, subtype, and prognosis of stroke, between people of European and African ancestry, of which only about 50% can be explained by traditional stroke risk facts. However, only a small number of genetic studies include individuals of African descent, leaving many gaps in our understanding of stroke genetics among this population. This review article highlights the need for and significance of including African-ancestry individuals in stroke genetic studies and points to the efforts that have been made towards this direction. Additionally, we discuss the caveats, opportunities, and next steps in African stroke genetics—a field still in its infancy but with great potential for expanding our understanding of stroke biology and for developing new therapeutic strategies.

Highlights

  • In order to search more broadly, search phrases were not included in quotation marks and each keyword referring to individuals of African ancestry (“Africans, African Americans, Blacks”) was included in a separate search

  • People of African ancestry, as a result of their longer history, have greater diversity, substructure pattern pattern diversity, higher higher levels levels of of admixture admixture and an intricate intricate population substructure compared of African

  • Ancestry develgenetic adaptations that have resulted in the presence of distinct allele frequencies, not oped genetic adaptations that have resulted in the presence of distinct allele frequencies, seen in orin among otherother ancestral groups/populations

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Summary

Introduction

Stroke is a complex and heterogeneous disease. Risk of stroke involves the interplay between genetic, epigenetic, and environmental factors. Stroke is the second leading cause of death and disability worldwide with over 13 million new strokes and 5.5 million deaths recorded in 2016 [1]. The overall incidence and burden of stroke in developed countries decreased by 42% in the period 1970–2008, it increased by more than 100% in low-income countries and in developing countries, where there is a disproportionate increase among individuals of African ancestry [2]. Community-based studies reported an age-standardized stroke incidence rate up to 316 per

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