Healthy "stroke belt" residents at higher risk

NEW YORK Mon Aug 20, 2007 7:35pm BST

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NEW YORK (Reuters Health) - Even relatively healthy men face an increased risk of stroke if they live in the southeastern United States, and they are also more likely to die from stroke than their peers living elsewhere in the country, a new study shows.

The findings provide some of the first evidence to-date that people living in the so-called "stroke belt" are more likely to die of strokes because they are more likely to have them, not because they get worse care, Dr. Virginia J. Howard of the University of Alabama in Birmingham notes in an editorial accompanying the study.

Even though researchers have been aware of the stroke belt for decades, the reason why the stroke rates there are so high remains a mystery. "I...believe that lifestyle habits are driving this result, although I cannot prove it," Dr. Tobias Kurth of Brigham and Women's Hospital in Boston, the lead author, told Reuters Health.

Kurth and his team looked at men enrolled in the Physicians' Health Study to see if an increased risk of stroke deaths would be seen in a group of relatively healthy men living in the region. Most of the men were white, free of heart disease and apparently otherwise healthy at the study's outset in 1982.

Among the 17,927 men included in their analysis, those living in the Southeast (Indiana, Kentucky, Tennessee, Virginia, North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana and Arkansas) were 22 percent more likely to suffer a stroke during the subsequent two decades than their peers living elsewhere in the country, the researchers found.

The risk for ischemic stroke, blockage of the blood flow to the brain causing tissue death, the most common type of stroke, was 30 percent greater.

The findings provide more evidence that the "stroke belt" is a real phenomenon, especially given that even relatively healthy, white men showed an increased risk of stroke if they lived in the region, Kurth noted.

The study wasn't able to delve too deeply into possible mechanisms for the phenomenon, Kurth said, although his group found no evidence that temperature or latitude were involved.

Based on the findings, he added, people living in stroke belt states should be particularly conscious of their risk factors for stroke -- which include high blood pressure, obesity, smoking and high cholesterol -- and take steps to control them.

SOURCE: Stroke, August 2007.

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