Risk for stroke tripled among young Black women with high blood pressure

Key takeaways:

• Young Black women with hypertension may have triple the risk for stroke vs. those without hypertension.
• Risk was independent of age, neighborhood socioeconomic status and residence in the Southeast.

Black women as young as 24 years diagnosed with hypertension may have up to a threefold greater risk for stroke at midlife vs. women without hypertension, researchers reported.

Findings from the Black Women’s Health Study were presented at the International Stroke Conference.

“This research was motivated by the glaring disparity I have seen in my own practice. Strokes are occurring at younger ages among my patients who identify as Black and among women,” Hugo J. Aparicio, MD, MPH, associate professor of neurology at Boston University Chobanian and Avedisian School of Medicine, said in a press release. “Early-onset stroke, particularly at midlife, is even more tragic because these patients often have families or are caretakers for sick family members.

“In addition, early-onset stroke at a younger age is associated with an increased risk of dying, as well as a burden of physical disability that creates many problems for stroke survivors and their families as they try to reintegrate into their normal lives and return to work,” Aparicio said.

The prospective study included 46,754 stroke-free Black women younger than 65 years from across the U.S. (mean age, 42 years).

History of hypertension was defined as self-reported physician diagnosis of high BP and use of an antihypertensive medication or diuretic, or use of an antihypertensive alone.

Incidence of ischemic and hemorrhagic stroke was self-reported with biennial health questionnaires.

At baseline, 10.5% of study participants aged 45 to 64 years had hypertension.

During an average follow-up of 17 years, stroke occurred in 3.2% of the cohort.

After adjustment for age, neighborhood socioeconomic status, residence in the southeastern U.S. (known as the “stroke belt”), smoking, BMI and diabetes, Black women with hypertension before age 45 years had a more than twofold greater risk for stroke during midlife (HR = 2.23; 95% CI, 1.79-2.78) compared with those with no history of hypertension.

In addition, risk for stroke was elevated among Black women with hypertension aged 45 to 64 years (HR = 1.69; 95% CI, 1.47-1.95), but was highest among women with hypertension aged 24 to 34 years (HR = 3.15; 95% CI, 1.92-5.16), researchers reported.

“My hope is that health care professionals are persuaded to pay special attention to high blood pressure screening and treatment over the life course for African American women, such as during childbearing years and both before and at the start of middle age. Health care policy changes are needed so that primary prevention is promoted and funded because by the time a Black woman has a stroke at middle age, it is often too late,” Aparicio said in the release.

Reference:

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Sources/Disclosures

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Source:

Aparicio HJ, et al. Abstract Poster HUP20. Presented at: International Stroke Conference; Feb. 7-9, 2024; Phoenix.

Disclosures:
Aparicio reports no relevant financial disclosures.

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