Are there racial differences in the clinical and angiographic features of symptomatic occlusive cerebrovascular disease between white and black patients?
There are distinct racial differences in the anatomical distribution of occlusive cerebrovascular disease, suggesting that lesions in black patients may arise from a disorder differing from typical atherosclerosis.
We compared clinical and angiographic features of 26 white and 45 black patients with symptomatic occlusive cerebrovascular disease. White patients had more transient ischemic attacks, carotid bruits, and more severe occlusive disease of the internal carotid artery origin. Blacks had more severe disease of the middle cerebral artery stem and supraclinoid internal carotid arteries. Differences were not explained by racial differences in the prevalence of hypertension, diabetes, hypercholesterolemia, or ischemic heart disease. Since the middle cerebral artery lesions in blacks do not correlate with other accepted epidemiologic, clinical, and laboratory markers of atherosclerosis, the lesions may arise from a disorder that differs from atherosclerosis.
Gorelick et al. (Sun,) studied this question.
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