There were 1,262 deaths from stroke in West Virginia in 2001. But African Americans are at particularly high risk. Nearly onefourth (23%) of stroke deaths among African Americans in West Virginia in 2001 occurred prematurely, or before the age of 65; among whites, only 10% of stroke deaths were premature.

According to the American Heart Association's Heart Disease and Stroke Statistics 2005 Update, blacks have almost twice the risk of firstever stroke compared with whites. Among the many faces of stroke, African Americans are disproportionately represented.

The American Stroke Association, a division of the American Heart Association, is working to change all that with a series of campaigns to reach those who are at highest risk. The first of three campaigns is an aggressive education and awareness initiative to reach African Americans. The association is in the early stages of the first campaign, and is ultimately working to create a movement around the serious health disparity issue of stroke in African Americans.

The first line of stroke defense for African Americans is to take the American Stroke Association's pledge. The pledge is a document for people to sign committing to not just "survive," but "thrive" by doing their part to make the right health choices for themselves, their families and their communities to prevent and overcome stroke.

In addition to signing the pledge, the association encourages people to know their family's health history, and work with their doctor on a plan to prevent and manage stroke risk factors. Some risk factors, such as family history, age, ethnicity and having a previous stroke put people at higher risk for stroke. These can't be controlled. Others, such as high blood pressure, smoking, diabetes, obesity or high cholesterol can be changed, treated or modified.

People with two or more of these risk factors and those who have had a stroke are at a higher risk for stroke:

High blood pressure (140/90 mm Hg or higher; optimal BP is less than 120/80 mm Hg) Smoking Being overweight or obese Physical inactivity High blood cholesterol Diabetes Family history of stroke Previous TIA or "ministroke"

While anyone can have a stroke, knowing about and managing risk factors reduces risk. African Americans are among those least aware of stroke risk factors, despite having a high prevalence of high blood pressure, obesity and tobacco use. In fact,

The prevalence of high blood pressure in African Americans in the United States is the highest in the world. Among blacks age 20 and older, 62.9 percent of men and 77.2 percent of women are overweight or obese. In 2001, 27.7 percent of blacks used tobacco products. Cigarette smoking approximately doubles a person's risk for stroke.

"While some risk factors can't be changed, stroke is not inevitable just because you have an uncontrollable risk factor. It simply means you need to pay special attention to risk factors that can be eliminated or controlled," says Claudette Brooks, MD, assistant professor, Department of Neurology, at West Virginia University Health Sciences Center and West Virginia University Stroke Center in Morgantown, West Virginia. Dr. Brooks serves as director of the WVU Neurovascular Lab and is a leading member of the WVU Stroke Center Team, Stroke Clinic and Stroke Research Clinic.

"In some instances, following a healthy diet and including regular exercise is not enough to reduce your risk of stroke, so ask your doctor about medication that will help and take it as prescribed. Remember, even if you are taking medication, a healthy diet and exercise continue to play an important role in your health," Brooks says.

Because those who suffer stroke are not the only victims, family members, including children, are among the many faces of stroke.

"When I had a stroke, it affected my eightyear old son. We had to take it one day at a time. At first there was an emotional toll on all of us. Once we understood how to deal with the sudden changes that affected our family, we were actually able to cope and build a stronger family unit," said Deanne Stein. Stein is a news reporter with WOWK Channel 13 in Huntington, West Virginia. She suffered an ischemicstroke at age 31 while at the news station preparing a story for the evening news.

Taking simple actions now against even one risk factor can help reduce the risk of having a stroke.

Commit to the American Stroke Association's stroke pledge and join the movement to fight stroke. Get your blood pressure checked. If it's 140/90 mm Hg or higher, control it. Visit your doctor regularly to monitor your health. If you smoke, stop! Start physical activity. Try to work up to accumulating 30 minutes of activity on most or all days of the week.

It is never too late to take action against stroke. For more information about the American Stroke Association or how you can join the "movement" to fight stroke, call 18884STROKE or visit strokeassociation.

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