By AMERICAN HEART ASSOCIATION NEWS
HOUSTON — Neurologists from the United States and Africa are meeting Thursday to explore the differences and similarities in stroke among Africans and African-Americans.
“We need to learn more about what is happening in native African populations and begin to compare and contrast the findings with populations of African ancestry who are living elsewhere,” said Philip B. Gorelick, M.D., co-moderator of the session, which is taking place in Houston at the American Stroke Association’s International Stroke Conference.
“This symposium gives us an opportunity to get a firsthand glimpse at some of the risk factors and outcomes in people of black African ancestry who are living in Africa and similar information on African-Americans who are generations away from living in Africa,” said Gorelick, medical director of the Hauenstein Neuroscience Center at Mercy Health Saint Mary’s in Grand Rapids, Michigan.
The presentations will explore stroke burden, risk factors and care gaps in Africa, as well as recent insights into the epidemiology of stroke in African-Americans, the state of clinical stroke research in Africa, and developing interventions to improve stroke survival and recovery in African-Americans.
The treatment and outcome of stroke in developing nations can vary greatly based on geography and the physical and genetic characteristics of stroke patients, said Yomi Ogun, M.B.Ch.B., president of the Nigerian Stroke Society.
“There are some important differences in stroke treatment in North America and in Africa,” said Ogun, professor of internal medicine at Lagos State University College of Medicine in Ikeja, Nigeria. “Clinicians in America talk about time from door to thrombolysis in terms of minutes. Over 80 percent of our stroke patients in Nigeria do not present until more than 24 hours after their strokes.
“Even if our centers had the facilities to administer early treatment, few of our patients arrive early. The lack of availability and affordability of neuroimaging, such as CT and MRI, in most centers are contributory challenges,” Ogun said.
Risk factors appear to be similar among native Africans and African-Americans. High blood pressure, diabetes, dyslipidemia and metabolic syndrome are leading contributors to stroke in Nigeria, Ogun said. The 2010 InterStroke Study found that risk factors for stroke appear to be consistent by age, race, ethnic group and continent.
“One assumes that the risk factors are the same,” Gorelick said. “Although in a potentially more agrarian culture, we may be finding that there is less obesity because there is more physical activity and less caloric intake.
“There may be dietary differences that could start to explain potential differences in stroke,” he said. “And we know that major tobacco companies are moving into developing countries and providing easy access to tobacco, which increases stroke risk.”
Other potential variations include the availability of strategies to diagnose, treat and prevent strokes. Differences in healthcare policy and healthcare delivery also may affect the delivery of stroke prevention and stroke care.
There is a lot still to learn about current trends and adapting and applying them to local needs, Ogun said.
“We are hoping that the symposium serves as a catalyst to create publications making these comparisons and contrasts,” he said. “We also hope that sharing lessons from both continents can help us all to improve stroke prevention as well as reduce disability and improve the outcome of stroke in our patients.”