"Stroke Necklace" Found In "Stroke Belt"

October 08, 1998

DALLAS, October 9 -- An area of the Southeastern United States that has been identified as the "stroke belt" due to its high rate of stroke-related deaths perhaps should be re-named the stroke "necklace," according to a study in this month's Stroke: Journal of the American Heart Association.

Researchers have noticed that residents in some parts of the "stroke belt" have a much higher risk of stroke than do people who live in nearby towns. Since these areas of high stroke risk are scattered, rather than lined up in a belt-like row across the map, the region tends to look more like a "necklace," says lead author Daniel Lackland, Dr. P.H., of the department of biometry and epidemiology at the Medical University of South Carolina, Charleston. The study compared stroke rates between the Anderson County and Pee Dee regions of South Carolina. "This is the first study to look at disease rates rather than just the number of stroke deaths," he says.

Lackland and his colleagues compared the number of strokes that occurred in the Anderson County and Pee Dee areas of South Carolina during 1990. The data from the two regions, which are 200 miles apart, were compared by age, race and gender. The overall rate of strokes in the Pee Dee area was 40 percent greater than that of Anderson County. This difference was even greater for younger people in the study. Stroke rates in the Pee Dee area were 58 percent higher for people 55 to 64, but 100 percent greater for people 45 to 54. Stroke rates were only 13 percent greater in Pee Dee for individuals over 65.

The higher rates of stroke at younger ages are of particular concern, he says. "These findings emphasize the need for control of stroke risk factors, particularly high blood pressure, at young ages." There doesn't seem to be a single explanation for the difference in stroke rates between Anderson and Pee Dee, says Lackland. "Before, people would say that maybe socioeconomics could explain the stroke belt -- like 'there are poor people in the South' -- but that doesn't explain the variations within the belt."

Co-authors are David L. Bachman, M.D.; Timothy D. Carter, M.D.; Derek L. Barker, M.S.; Stephen Timms, M.D.; and Harvinder Kohli, M.D.
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Media advisory: Dr. Lackland can be reached by phone at (843) 876-1141; by fax at (843) 876-1143; or by e-mail at lackland@musc.edu (Please do not publish number or email address.)
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American Heart Association

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