Stroke disparities tied to common risk conditions, not ethnicity alone
A south London study examined more than 650,000 primary care records from 2005 to 2021. It found that Asian and Black patients were more likely to have diabetes or high blood pressure, but once those conditions were present, stroke risk was similar across ethnic groups. The researchers conclude that differences in traditional risk factors largely account for ethnic inequalities in stroke.
Researchers at King's College London reviewed electronic primary care records from over 650,000 patients across 41 Lambeth practices, covering 2005 to 2021. They tracked Asian, Black, and white patients through three cardiometabolic conditions: high blood pressure, diabetes, and high cholesterol, using a multistate model to estimate transitions between health states.
Black patients were about twice as likely to develop high blood pressure and more than twice as likely to develop diabetes as white patients. Asian patients had roughly 50% higher hypertension risk and three times the diabetes risk. Yet after these conditions appeared, progression to stroke was similar across ethnic groups. The study appears in BMC Public Health.
This finding may shift attention toward preventing and managing diabetes and hypertension in communities with higher burdens of these conditions, especially Black and Asian patients in similar urban settings. If risk after diagnosis is comparable, access to primary care, screening, and treatment could matter more than ethnicity-specific stroke pathways. It could inform clinical conversations and public health planning, though the study's local sample means broader effects remain uncertain.