Cerebrovascular Disease in African Americans

It was an honor to be selected as the first lecturer for the American Heart Association (AHA) Presidential Symposium in conjunction with the 23rd International Joint Conference on Stroke and Cerebral Circulation. I wish to thank Dr Martha Hill, the AHA President, for the invitation to participate. Dr Hill has had a longstanding interest in cardiovascular health issues in the African American community. I also wish to thank Drs Edward Cooper and Jacqueline Washington, who served as panel discussants for the symposium. Since 1981, I have been carrying out epidemiological studies of stroke in African Americans. The studies have included both observational ones and clinical trials. At the present time, we are completing a secondary stroke prevention trial: the African American Antiplatelet Stroke Prevention Study (AAASPS). I now provide an overview of cerebrovascular disease in African Americans. I begin my discussion with a brief review of the constructs race and ethnicity.Williams has critically examined the scientific consensus on the conceptualization of race.1 The United States government recognizes four racial groups—white, black, Asian or Pacific Islander, and American Indian or Alaskan Native—and one ethnic category, Hispanic. The distinction between race and ethnicity may be obscured, however, as some Hispanics may prefer to refer to themselves as a racial category.1 In the social science literature, the early definitions of race used the term to capture “physical” or “biological” characteristics that differentiated human populations. The term was then extended to encompass biological and social interaction. More recent definitions of race have discredited the early definition that included physical or biological characteristics because in general, phenotypic characteristics do not correlate well with biochemical or other genetic characteristics, and there may be more genetic variation …