The Riddle of the Southeastern Stroke Belt

Abstract:  The southeastern United States has long been recognized as an area of excess disease risks. In addition to overall rates, am earlier onset of disease and risk factors are found in the geographic area. The racial and geographic disparities in stroke and cardiovascular disease are consistent with patterns of hypertension. The population attributable risks for 30-year mortality are nearly 25% in white men and 45% in black men. In particular, the prevalence of hypertension are higher among African Americans, however the high blood pressure control rates are lower compared with African Americans. While the disparities are partially explained by traditional factors such as body size, much remains unexplained. These risks and associations are similar to the patterns of low birth weight in the population. Likewise, hypertension and hypertension-related outcomes have a fetal and early-life origin as demonstrated by increased risk among individuals with low birth weight.

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