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(Circulation. 2007;116:2099-2100.)
© 2007 American Heart Association, Inc.

Editorial

Preventing Stroke

Does Race/Ethnicity Matter?

Philip A. Wolf, MD; William B. Kannel, MD

From the Boston University School of Medicine, The Framingham Heart Study, Boston University School of Medicine, Boston, Massachusetts.

Correspondence to Dr Philip A. Wolf, Professor of Neurology, Principal Investigator, The Framingham Heart Study, Boston University School of Medicine, 715 Albany St, B-622, Boston, MA 02118-2526. E-mail pawolf@bu.edu

Key Words: Editorials • ethnicity • genetics • race • stroke • subcortical infarction

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Stroke, the third leading cause of death in the United States, is also the chief cause of neurological disability in the elderly. Lifetime risk of stroke at age 65 years is estimated to be 1 in 5 in women and 1 in 6 in men in the Framingham Study population.¹ Despite improvements in management of the acute stroke and in rehabilitation poststroke, it is clear that prevention holds the key to decreasing the toll of cerebrovascular disease. In recent years, it has become increasingly clear that clinically inapparent strokes detected on magnetic resonance scan of the brain, so-called "silent" strokes, exert a discernible impact on brain function.² Measurable reduction in cognitive performance that leads to vascular cognitive impairment, depressed mood, and impaired gait are consequences of these "silent" strokes.³ In addition, persons harboring these infarcts and a large burden of white-matter hyperintensities are predisposed to develop clinically apparent cerebral infarctions. Further, the presence of elevated levels of stroke risk factors exerts a measurable effect on brain structure and function, which results in reduced total cerebral volume and an increased presence and volume of white-matter hyperintensities on magnetic resonance scan of the brain, as well as reduced cognitive performance, particularly on tests of executive function.⁴

Article p 2157

In this issue of Circulation, Markus et al report on the results of the difficult task of discerning variations in frequency and risk factors that predispose to the different stroke subtypes in black and white patients in South London.⁵ Analysis of possible . . . [Full Text of this Article]