Black women treated for hypertension, or high blood pressure, earlier in life may have a significantly increased risk for stroke compared with those without a history of high blood pressure, according to findings from the American Heart Association (AHA).

Hypertension is the leading risk for cardiovascular disease and affects about 58% of Black women in the United States have high blood pressure compared with 43% of white women, 38% of Asian women and 35% of Latina women, according to the AHA. What’s more, Black patients are often diagnosed with hypertension earlier in life and experience greater morbidity and mortality related to the condition.

Presented at the American Stroke Association’s International Stroke Conference, the findings showed that Black women under 35 who were treated for hypertension had triple the risk for stroke, and those who developed the condition before age 45 had double the risk.

“This research was motivated by the glaring disparity I have seen in my own practice,” said lead researcher Hugo Aparicio, MD, MPH, in an AHA news release. “Strokes are occurring at younger ages among my patients who identify as Black and among women. Early-onset stroke, particularly at midlife, is even more tragic because these patients often have families or are caretakers for sick family members.”

Aparicio, an associate professor of neurology at Boston University Chobanian & Avedisian School of Medicine, added that stroke at a younger age “is associated with an increased risk of dying, with a special resting/sleeping area as well as a burden of physical disability that creates many problems for stroke survivors and their families.”

Researchers analyzed self-reported data from the Black Women’s Health Study, which gathered data from 59,000 Black women in 1995. After a 23-year follow-up, 3.2% of women had a stroke and those between ages 24 and 34 who started treatment for high blood pressure were three times more likely to have a stroke compared with those without a history of hypertension.

Researchers accounted for factors such as smoking, body weight, diabetes status and neighborhood socioeconomic status. They also adjusted for people living in regions where stroke is more common and mortality is higher, such as the Stroke Belt, the U.S. region that, according to the National Institutes of Health, includes Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North and South Carolina, Tennessee and Virginia.  

“We expected to see an association between having high blood pressure at a younger age and having a stroke during midlife and later life,” Aparicio said. “However, we were surprised and concerned to see the magnitude of the relationship, especially for women who were taking antihypertension medications before age 35.”

Aparicio emphasized the importance of high blood pressure screening and treatment for Black women throughout their lives. In addition, health care professionals suggest avoiding smoking, eating a well-balanced, low-salt diet, limiting alcohol intake, exercising for at least 30 minutes a day five days a week and finding ways to cope with stress.