'Stroke Belt' disappearing

By Rhonda Rowland
CNN Medical Correspondent

FORT LAUDERDALE, Florida (CNN) -- Alabama and Mississippi are falling out of the so-called "Stroke Belt," a term given to the southeastern United States where stroke rates are highest, researchers said Wednesday.

But researchers presenting their data at the American Stroke Association's annual conference here said they are not sure why they are seeing this trend.

"The incidence of stroke in these areas is 10 to 20 percent less than stroke belt states like Georgia, Tennessee and South Carolina," said George Howard, chairman of the biostatistics department at the University of Alabama at Birmingham.

At the same time, Howard said, stroke rates appear to be unexpectedly high in Washington and Oregon. "While stroke rates are steadily declining in most areas of the country, they're not falling as fast in the northwest," he said.

Another intriguing finding, researchers said, was that New York City -- which has the highest rate of heart disease in the country -- has the lowest stroke rate. The stroke rate in New York is about two-thirds lower than what's seen in Birmingham, Alabama.

"We found Miami has the second lowest stroke rate in the country," said Howard, "but if you drive to northern Florida, to the Jacksonville area, you've entered part of the 'Stroke Belt.'"

Despite the shift in stroke rates, those at highest risk for stroke continue to be African-Americans living in the South.

"Stroke rates have steadily declined in African-Americans while they've plateaued in whites," said Howard. "Proportionately, more blacks die from stroke up to age 70, but after that stroke deaths are about equal among blacks and whites."

Still, the stroke rate for blacks is about 40 percent greater than the rate for whites.

Researchers said more studies are needed to find out what is causing the regional differences in stroke rates.

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American Stroke Association, a Division of American Heart Association
American Heart Association 1999 Heart and Stroke A-Z Guide
National Stroke Association
National Institute of Neurological Disorders and Stroke (NINDS)

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