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Black women under 35 with high blood pressure may have triple the risk of stroke, study says

Researchers analyzed data from nearly 47,000 participants in Boston University’s Black Women Health Study, the largest follow-up study on the health of Black women.

Black women who develop high blood pressure before age 35 may have triple the risk of having a stroke by middle age, new data suggests.

The findings come as the medical community has noted with concern that the rates of stroke are increasing among middle-aged adults, while stroke rates in older individuals have been steadily decreasing over decades, according to lead study author Dr. Hugo Aparicio, an associate professor of neurology at Boston University. The study will be presented next week at the American Stroke Association’s international conference in Phoenix. 

“The message needs to go out that hypertension and stroke are not diseases of the elderly,” Aparicio said. “These are things that can happen to younger people — and that Black women in particular have to be aware of the increased risk and advocate for themselves.”

Black women are twice as likely to experience a stroke compared to white women, and  50% more likely to have high blood pressure, according to the Office of Minority Health. 

Strokes are more common in Black Americans than any other racial group in the U.S., the American Stroke Association says. Death rates are also higher.

Dr. Amber Johnson, a cardiologist and assistant professor of medicine at the University of Chicago, called the data in the study “alarming” but said she’s not surprised.

“I tend to see a lot of younger, Black women and there are higher rates of hypertension that I’m seeing,” Johnson said. 

In the new study, which has not yet been published in a peer-reviewed journal, Aparicio and his colleagues looked at data from nearly 47,000 women in the Black Women’s Health Study, which has tracked the health of a huge group of Black women since 1995. 

All of the women were stroke-free at the beginning of the study, and were followed for up to 23 years. The researchers looked at what age women developed high blood pressure — in this case, based on when they started treatment for it — and also looked at whether they had a stroke during the study period. 

They found that compared to women who didn’t have high blood pressure, Black women who developed high blood pressure before 35 had 3.1 times the risk of having a stroke by middle age. Those who developed high blood pressure before 45 had 2.2 times the risk of stroke, and high blood pressure from ages 45 to 64 was tied to a 1.69 times higher risk of stroke. 

A stroke is a “very devastating event” that can cause permanent damage to the brain and permanently alter a person’s speech and mobility, said Dr. Anais Hausvater, a cardiologist at NYU Langone Health in New York City. The study urges Black women to see their doctor and get their risk factors checked early, she said.

“A lot of people don’t go to see a doctor in their 30s because they’re presumed to be healthy,” Hausvater said. “They don’t feel any symptoms because hypertension is a silent disease. So, people often don’t know that they have hypertension.” 

Johnson said that factors like underdiagnosis and a lack of treatment also put many Black women at risk of developing hypertension and stroke.

While lifestyle choices like diet and smoking can affect blood pressure, many patients may not recognize that hypertension can also be inherited, she said.

Experts said that lifestyle changes, like increasing physical exercise, limiting salt and eating healthy foods, can help decrease risk. 

The sooner doctors treat hypertension, the sooner patients can lower their risk of stroke and heart disease, Hausvater said.

Screening for high blood pressure and controlling blood pressure levels are some of the prime elements for preventative care, “before people actually have a stroke,” Arapicio said.

“By the time somebody has a stroke, it’s too late,” he said.