High Stroke Risks Due
To Racial Differences
By Robert Conn
Bowman Cray School of Medicine
Deaths from strokes are substantially 1
more common among black men and black
women than among white men or white
women.
"Part of the difference in stroke deaths
occurs because of higher prevalence of
stroke risk factors among U.S. blacks than
whites: more high blood pressure, more dia
betes, a greater percentage of smokers, more
obesity," said Dr. Gregory L. Burke, associ
ate professor and vice chairman of the
Department of Public Health Sciences.
Burke has been studying racial differ
ences in stroke and related diseases for more
than 10 years. Based on his work, Burke
believes the difference in mortality between
blacks and whites is not due primarily to
genetic differences.
"Skin color alone does not cause a per
son to be at greater risk of disease, with the
exception of some specific genetic diseases,
such as sickle cell anemia," Burke said. "We
believe that the differences seen between
African Americans and whites are related to
differences in known risk factors and eco
nomic factors, which are preventable.
"If appropriate dietary and behavioral
recommendations were followed, known
risk factors were created, and medical care
was the same among blacks and whites," he
said, "we would expect virtually no differ
ence in mortality."
He cited a study done in Charleston,
S.C., comparing a group of black profes
sionals and businessmen with a randomly
selected group of blacks and whiles from the
general' population. The black professionals
and businessmen had the best heart disease
If
risk profile and the lowest rates of subse- _
qucnt heart disease.
Bowman Gray faculty members are
pursuing possible reasons for differences in
mortality through three major studies:
? AR1C ( Atheroschlerosis Risk in
Communities), is a study of 16,000 middle
aged persons in four U.S. communities, with
4,000 participants in Forsyth County. ARIC
is designed to belter understand how risk
factors relate to development of heart dis
ease and strokes. About 5,000 of the 16,000
participants are black. Burke said investiga
_ tors hope to belter answer why racial differ
ences in disease exist, and what steps could
be taken to reduce those differences.
? CHS (Cardiovascular Health Study),
is investigating factors associated with heart
disease risk in older adults.
? SECORDS (Southeastern Consortium
on Racial Differences in Stroke) aims at
understanding why more blacks die of
stroke than whites. The questions being
explored include: are there differences in
hospital treatment? differences in rehabilita
tion? Are the strokes more severe?
Burke said investigators already know
the percentage of hemorrhagic ? bleeding
? strokes is higher in blacks, while whiles
tend to have more strokes caused by blood
clots or other debris lodging in the arteries
of the brain. These differences may con
tribute to mortality differences, since hemor
rhagic strokes tend to be fatal more often.
Studies Show Prostate Cancer
Is On The Rise
By Karen Richardson
Bowman Gray School of Medicine
If you're a black man in North
Carolina, your chances of developing
prostate cancer are 25 percent higher than
for white men. The disease, which kills
35,000 men each year, is the most common
cancer among men.
At the Bowman
Gray School_of Me^
dicine, researchers are
looking for what causes
the disease and also
developing a program
to encourage bl^ck men
to get regular prostate examinations.
A digital rectal exam, often combined
with a blood test, is the most current way to
diagnose the disease early, when the chance
of cure is higher.
? Studies at the Comprehensive Cancer
Center of Wake Forest University, however,
revealed that black men are less likely than
white men to have attended a free screening
before and less likely to have had a digital
rectal exam in the previous year.
The researchers asked black men who
attended free community prostate screenings
about their attitudes, beliefs and knowledge
about prostate screening. In a study funded
by the J. Paul Sticht Center on Aging, they
also questioned patients at Wake Forest
University Physicians and Reynolds Health
Center.
This information will be used to design
a program to educate black men about the
-i importance of screening.
In another study, researchers want to
find out if a chromosomal abnormality is
linked to prostate cancer. This information
could be used to identify men likely to
. develop the disease so they could receive
J regular screenings.
"If we can identify high-risk groups,
they could be screened more often," said
Electra Paskett, assistant professor of public
health sciences at Bowman Gray School of
Medicine.
Doctors already know, for example,
that black males, men over 65 and men with
a family history of prostate cancer run a
higher risk of developing the disease than
other men.
"If we can find out what causes prostate
cancer, we can encourage a change in
behavior to prevent it, "Paskett said.
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