Stroke related mortality is higher in women compared to men and accounted for 62% of the US stroke related deaths in 2002. African American women appear to have almost twice the risk of first-time stroke compared to whites. Qureshi et al. (2006) in a prospective study examined racial and gender differences in long-term survival following ischemic stroke in a well defined cohort of patients.

The authors reported that African American women had higher rate of mortality (relative risk 2.1) after adjustment for all potential confounders except diabetes mellitus. After adjustment for diabetes, the difference was insignificant although a 70% greater risk of 1-year mortality was still observed.

The authors concluded that compared with whites and men, African American women have a lower 1-year survival following ischemic stroke. This phenomenon may be due to factors such as the higher prevalence of diabetes, obesity and metabolic syndrome in African American women and ethnic difference in the modification of risk factors such as hypertension, elevated cholesterol and smoking.

Authors also noted that ethnic and gender differences in utilization of medical intervention (e.g. endarterectomy) contribute to differences in the risk of recurrent stroke and cardiovascular death in patients with ischemic stroke. The authors suggested greater monitoring, counseling and intervening in African American women in regard to risk factor modification.