ENGLAND — People from Black African and Black Caribbean backgrounds in England experienced stroke at more than twice the rate of their white counterparts between 2020 and 2024, according to a study by researchers at King's College London presented at the European Stroke Organisation conference. The study also found that those communities were less likely to receive timely follow-up care after a stroke.

The research analysed 30 years of data from the South London Stroke Register, one of the longest-running population-based stroke registers in the world, which recruits every person who has had a stroke in a defined area. Within a population of 333,000 people covered by the register, 7,726 strokes were recorded.

Stroke incidence in the register fell by 34% between 1995-99 and 2010-14, but rose by 13% between 2020 and 2024. During the most recent period, stroke incidence was 131% higher in Black African populations and 100% higher in Black Caribbean populations compared with white counterparts. Stroke survivors from a Black African background experienced a stroke about 10 to 12 years earlier than their white counterparts and were 34% less likely to receive NHS follow-up care, which the researchers said is critical in the period immediately after a stroke for preventing another one.

"This trend may partly reflect the lasting impact of the Covid-19 pandemic, which reduced access to primary care, blood pressure monitoring and prescribing, particularly affecting black and deprived communities," lead author Dr Camila Pantoja-Ruiz said. "These patterns of increased stroke risk in these communities may also be influenced by broader factors, including racism, unconscious bias and socioeconomic circumstances, which can impact access to and quality of care."

People from black backgrounds are up to 47% more likely to have high blood pressure and up to twice as likely to have diabetes than their white counterparts, after adjusting for other risk factors including socioeconomic background. Pantoja-Ruiz also said: "Less timely follow-up leaves patients at elevated risk for longer and may be influenced by mistrust in healthcare services linked to historical and ongoing experiences of discrimination."

"These findings reveal that stroke is rising again and that black African and black Caribbean communities are bearing a disproportionate burden," Maeva May, director of policy at the Stroke Association, said. "This rise is shaped by higher rates of undetected and under-treated risk factors for stroke, including high blood pressure – which is the cause of around half of all strokes – and diabetes. This is further exacerbated by the broader social and economic circumstances, such as poor housing, which shape health long before a stroke occurs."

"The challenge now is making sure that this support reaches everyone equally. The government must prioritise stroke and be guided by the voices of communities who are adversely affected by this life-changing condition," May added.