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Georgetown research identifies key reasons racial disparities exist in emergent stroke treatment
Date:6/30/2011

found that blacks were a third less likely to be treated with tPA than whites," explains Kidwell. She says understanding the reasons for this disparity are critical for making change in the future.

Researchers found that blacks were more likely to arrive at a hospital after the narrow treatment window during which tPA must be administered to be effective. Even if they arrived within three hours of symptom onset, blacks were still half as likely to be treated with tPA than whites.

"A key reason why fewer blacks received tPA appears to a greater rate of pre-existing medical conditions such as uncontrolled hypertension, recent stroke or being on blood thinners," Kidwell explains. "These conditions make tPA administration unsafe."

Uncontrolled hypertension accounted for nine percent of the patients who didn't receive tPA. An additional 10 percent had a recent stroke or evidence of a prior hemorrhage.

After accounting for the differences, the researchers found that of the tPA eligible patients, the treatment rate for blacks and whites was actually similar.

"Our study not only demonstrates that there is a racial disparity in acute stroke treatment rates in this predominantly African-American urban population, but identifies two important underlying reasons: African-Americans do not get to the hospital early enough for treatment and they have a greater number of medical reasons for not receiving treatment," says Kidwell.

"Interventions designed to increase treatment in this population need to focus on culturally relevant education programs designed to address barriers specific to this population," she says.


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Contact: Karen Mallet
km463@georgetown.edu
Georgetown University Medical Center
Source:Eurekalert

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