Stroke Mortality In Women Research Articles

Resting and ambulatory blood pressure differences in Afro-Caribbeans and Europeans.

To investigate why mortality from stroke in people of Afro-Caribbean origin is twice the average for England and Wales, we examined 1166 European and Afro-Caribbean people in London. Age-standardized median systolic blood pressure was 6 mm Hg higher (128 versus 122 mm Hg) in Afro-Caribbean than European men and 17 mm Hg higher (135 versus 118 mm Hg) in Afro-Caribbean than European women. Migrants from West Africa and the Caribbean had similar blood pressures. Body mass index was higher in Afro-Caribbean than European women, accounting for 4 mm Hg of the systolic difference. Diabetes prevalence was 16% in Afro-Caribbeans and 5% in Europeans (P < .001), accounting for 1 mm Hg of the difference in systolic pressure in men and 2 mm Hg in women. In participants not taking antihypertensive medication, mean fall in ambulatory systolic pressure between daytime and nighttime, adjusted for resting blood pressures, was 24 mm Hg in Europeans and 18 mm Hg in Afro-Caribbeans (P = .05), and percent day-night fall in systolic blood pressure adjusted for resting systolic pressure was 17% in Europeans and 12% in Afro-Caribbeans (P < .05). This difference persisted when men and women and normotensive and hypertensive individuals were examined separately. We estimate that the differences in blood pressure between Afro-Caribbeans and Europeans may be enough to account for ethnic differences in stroke mortality in women but not men. The reasons for the high prevalence of hypertension and related morbidity in this and other populations of African descent remain to be established.

International trends in stroke mortality: 1970-1985.

We compared the pattern of cerebrovascular disease (stroke) mortality in men and women aged 40-69 years in 27 countries during 1970-1985 with the decline in coronary heart disease mortality during the same period. Stroke mortality rates declined in 21 and 25 countries for men and women, respectively. In 23 countries the decline in stroke mortality in women was greater than that in men. Countries with the highest rates of stroke mortality are also those with the least favorable secular trend. The rate of decline for stroke mortality is greater than that for coronary heart disease mortality in those countries that experienced a decline in both categories. International comparisons of risk factor levels over time are required to explain the striking differences between countries.

Family history of stroke as an independent predictor of ischemic heart disease in men and stroke in women.

The major known cardiovascular risk factors, age, cholesterol, blood pressure, cigarette smoking, and diabetes and family history of heart attack, explain only a proportion of cardiovascular disease. In a study of 1,491 men and 1,924 women aged 50-79 years in an upper middle-class Caucasian population in Rancho Bernardo, southern California, who were free of known cardiovascular disease at baseline in 1972-1974 and who were followed for an average of nine years, family history of stroke in any first-degree relative was an independent predictor of ischemic heart disease mortality in men 50-64 years of age (relative risk = 3.3, p less than 0.05) and of stroke mortality in women 50-79 years of age (relative risk = 2.3, p less than 0.05) after controlling for all the above risk factors. In contrast, family history of stroke was not predictive of stroke mortality in men or of ischemic heart disease mortality in women. These results suggest that family history of stroke may be used as a marker for high-risk subjects and to identify and investigate other major genetic or environmental determinants for cardiovascular disease, particularly sex differences.