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The Challenges Continue

Ralph L. Sacco, MS, MD

JAMA. 2003;289:3005-3007.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Stroke continues to have a disproportionate public health impact on blacks compared with whites in the United States. Excess mortality from stroke has been reported among blacks and remained significant despite recent declines in stroke mortality.¹ Data from national samples, the Greater Cincinnati Stroke Study, the Baltimore Washington Cooperative Study, and the Northern Manhattan Study have consistently demonstrated 2-fold to 3-fold greater stroke incidence rates for blacks than whites in the same communities.^2-4 Blacks not only have stroke more frequently but also have a greater risk of stroke due to small-vessel disease leading to ischemic lacunar infarction and intracerebral hemorrhage, as well as ischemic infarction from large-artery intracranial atherosclerosis.^5-6 The aging and continuing growth of the black population will undoubtedly lead to future increases in the number of blacks with stroke. This major public health concern has led to a number of challenges to stroke . . . [Full Text of this Article]

Author Affiliation: Departments of Neurology and Epidemiology, Columbia University College of Physicians and Surgeons, Mailman School of Public Health, and the Gertrude Sergievsky Center, The New York Presbyterian Hospital, New York, NY.

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