Study Finds Racial Disparity in Stroke Treatment
Whites are five times more likely than blacks to receive the drug TPA for treatment of ischemic stroke, according to a study by researchers at the University of California-San Francisco, the Las Vegas Sun reports. Appearing in the May issue of the journal Stroke, the study reviewed records of 1,195 ischemic stroke patients treated at 42 academic medical centers in 1999. Of those studied, 5.3% of whites received TPA, while only 1.1% of blacks received the treatment. However, researchers found low overall use of TPA among all patients. TPA is the only FDA-approved treatment for strokes caused by blood clots, but it must be administered within three hours of the onset of a stroke to be effective, and it can cause bleeding in the brain. Researchers said that a "large racial disparity persisted" even after considering such factors as age, gender, severity of the stroke and type of insurance. However, Dr. S. Claiborne Johnson, assistant professor of neurology at UCSF and one of the study's authors, said that race may only be a "subtle" factor in the number of patients receiving TPA treatment, noting that other studies show that blacks are "more likely" to refuse "risky" medical treatments. Johnson said, "I think doctors internalize that. Because of that, they may not be offering the drug to African Americans as frequently, thinking that they may not accept the risk." In addition, other factors may contribute to the disparity. Dr. Mark Alberts, professor of neurology at Northwestern University Medical School, said blacks "tend" to arrive later at the hospital once symptoms appear and "more frequently" have other conditions that make TPA treatment unsafe (Las Vegas Sun, 4/3).