Stroke Disparities: The disparity in stroke outcomes between racial groups has long puzzled scientists, particularly the higher incidence and severity of strokes among Black individuals. Recent research sheds light on the role of genetics in blood clotting, potentially revolutionizing stroke treatments.
Dr. Calvin Smith, associate professor of internal medicine at Meharry Medical College, Nashville, Tennessee, highlights the significance of this breakthrough, stating, “It could have a huge impact on how we treat strokes in African Americans.”
The study, published in the Journal of Clinical Investigation (JCI) on July 28, focused on a PAR4 gene mutation more prevalent in Black individuals (60%) compared to White individuals (20%). This gene affects platelets, the components responsible for blood clotting. While accidental clots can prevent excessive bleeding, they also pose a risk for strokes.
Lead author Robert Campbell, a professor at the University of Utah School of Medicine, explains, “Heart attacks, strokes, and venous thrombosis can happen when platelets are overactive or don’t work right.”
The research involved examining 7,620 Black participants with the PAR4 mutation. Two specific variations of the A gene were identified, which increased the risk of stroke occurrence and impacted healing. Additionally, tests on mice revealed that the PAR4A gene alteration exacerbated strokes in the animals.
Interestingly, the study also investigated the efficacy of stroke medications such as Brilinta and aspirin. Results showed that these drugs offered protection to White mice with the PAR4 gene, but not to their Black counterparts.
Addressing the lack of diversity in medical studies, Dr. Smith emphasizes the importance of involving more Black individuals in research. “Compared to Whites, there are a lot fewer African Americans who agree to studies and take part in them,” he points out. Historical distrust, stemming from incidents like the Tuskegee experiment and African-American pregnancy testing, has contributed to this disparity.
To advance precision medicine, an innovative approach tailored to individual genetics, environments, and lifestyles, diverse trial participants are essential. Dr. Smith urges African Americans to actively participate in such studies, asserting that their voices need to be heard in shaping healthcare decisions. “If we find that the medication makes a big difference in how we are treated, we could hurt ourselves by not taking part in these research studies and letting them decide where we belong in society,” he concludes.
The new findings offer hope for a better understanding of stroke risk factors in different racial groups and present an opportunity to address health disparities through personalized and inclusive medical research.
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Our Reader’s Queries
What are the ethnic disparities in stroke?
African American patients face double the risk of experiencing their first stroke compared to White patients. Additionally, the likelihood of having a stroke can vary based on where a person lives, such as in the stroke belt region.
What is the meaning of health disparities?
Preventable inequalities in health, such as disease, injury, and limited opportunities for optimal health, are experienced by socially disadvantaged populations. Despite progress in research, practice, and policy, disparities in youth health risk behaviors continue to exist.
Income and education levels are social determinants of health that can predict negative health outcomes, including an increased risk for stroke. These factors are often beyond the control of clinicians and can create barriers to providing optimal patient care.
What happens in the first 3 days after a stroke?
In the days following your stroke, it’s normal to feel extremely exhausted as your body works to bounce back from the big event. At the same time, your medical team will be busy pinpointing the specific kind of stroke, its location, the extent of the damage, and the resulting impacts. They might also conduct additional tests and blood work to gather more information.