Investigators from the Department of Neurology at Cedars-Sinai have new information on stroke-related health disparities. In a study published in the peer-reviewed journal Scientific Reports, they determined that one measure of the lifetime impact of stressors such as racism could help explain disproportionately poor stroke outcomes in Black patients, who are at historically greater risk of stroke, and of death from stroke, than other racial groups.
The body responds to stress by releasing hormones that trigger a “fight-or-flight” response, raising heart rate, breathing rate and blood pressure. The response also elevates the level of infection-fighting white blood cells and blood levels of a protein called albumin, among other inflammatory and endocrine biomarkers.
In their study, researchers reviewed information on 704 patients participating in the Intracerebral Hemorrhage Outcomes Project, which collected data on patients experiencing intracerebral hemorrhage, the second-most common and most deadly type of stroke. It is characterized by bleeding into the brain.
The project collected the blood sugar, blood pressure, heart rate, white blood cell count and albumin levels of patients hospitalized with stroke. After their discharge from the hospital, patients were contacted by phone and given a brief standardized test designed to detect cognitive impairment, including problems with memory and ability to focus, plan and problem-solve.
Investigators assigned each patient an allostatic load score—with a higher score indicating greater exposure to chronic stressors—based on their physical test results. They then examined the relationship between each patient’s allostatic load score and their score on the cognitive test.
Among the patients, 248 identified as white, 195 as Black and 261 as Hispanic. Allostatic load and cognitive impairment were not greater in any racial group. However, researchers found that Black patients with higher allostatic load also had greater cognitive impairment after discharge from the hospital.
