[acb-diabetics] ischemic stroke rate rate higher for black men vs white men and women when they are obese

[Patricia LaFrance-Wolf]

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The most obese black women were at 43% higher risk of stroke than the
thinnest black women, while the fattest black men had more than three times
the stroke

risk of their thin counterparts, depending on the measure of obesity used,
researchers reported.

 

Hiroshi Yatsuya, MD, of the University of Minnesota, and colleagues
concluded that,."Based on the fact that we consistently found positive
associations

between obesity measures and ischemic stroke incidence in blacks in the
present study, we believe that obesity, however it is measured,
significantly increases

ischemic stroke risk in blacks as well as in whites.

 

Stroke is the third leading cause of death in the U.S., and incidence of
stroke among blacks is about twice that of whites. But while research has
established

that being overweight raises risk of stroke in whites, it was not clear
whether obesity put blacks at higher risk of stroke, too.

 

"We tested the hypothesis that there are differences in the association for
black versus white men and women," Yatsuya and colleagues wrote.

 

The researchers analyzed records of 13,549 middle-age black and white men
and women in four U.S. communities who participated in the Atherosclerosis
Risk

in Communities Study (ARIC).

 

The data included measurements of the subjects' body mass index (BMI), waist
circumference, and waist-to-hip ratio taken between 1987 and 2005. The
participants

started the study free of cancer and cardiovascular disease, but during the
two decades of the study, 598 suffered ischemic strokes, based on hospital

records.

 

Relatively speaking, blacks suffered two to three times the number of
strokes of their white counterparts.

 

The thinnest white women suffered about 1.2 strokes per 1,000 person-years
on average, while their black counterparts suffered 4.3 per 1,000
person-years.

The difference was more dramatic when comparing the heaviest white women
(2.2 strokes per 1,000 person years) with the heavy black men (8.0
strokesper

1,000 person years).

 

While their findings agreed with previous research that linked obesity to
stroke risk in whites, Yatsuya and colleagues found stronger evidence than
most

previous studies for such an association in blacks.

 

They generally found a linear relationship between obesity and stroke risk
for both whites and blacks, with a person's risk increasing as they grew
heavier.

"Higher disease burden of stroke in blacks exists, and is at least partly
due to their higher obesity level compared to whites," Yatsuya said.

 

Hypertension and diabetes attenuated the effect of obesity on the risk of
stroke.

 

"Given the strong association between obesity and hypertension and other
risk factors, including diabetes mellitus, obesity would be an important
target

for the prevention of ischemic stroke," the investigators wrote.

 

"Strictly speaking, clinical trials are now needed to determine whether
obesity prevention or control would actually decrease stroke incidence,"
Yatsuya

said. "However, it would be reasonable to say we can prevent stroke
targeting at obesity control and prevention."

 

Yatsuya H, et al "Race- and sex-specific associations of obesity measures
with ischemic stroke incidence in the Atherosclerosis Risk in Communities
(ARIC)

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