First-of-its-kind study associates obesity with poorer stroke outcomes in non-white patients

April 26, 2018, Louisiana State University

Research led by LSU Health New Orleans faculty has found that obesity contributed to poorer outcomes in non-white patients who had hemorrhagic strokes. It is one of the few studies examining outcomes of patients with obesity following intracerebral haemorrhage (ICH) and is the first such study conducted within the stroke belt of the US with a racially diverse population. The findings were published this month in Obesity Science & Practice Early View.

"We reported on the racial differences in outcome of with obesity following hemorrhagic stroke (intracerebral hemorrhage)," says lead author Dr. Ifeanyi O. Iwuchukwu, LSU Health New Orleans Assistant Professor of Neuroscience. "We defined good outcome based on the likelihood of discharge home or a rehabilitation center."

The retrospective study examined data on 428 patients from the Get with the Guideline-Stroke database. Data included demographics; medical history; clinical, laboratory, and imaging characteristics; BMI and obesity classification; as well as discharge disposition. Fifty percent of the patients were female, 49.1% were non-white (43.7% African-American, 0.9% Asian, 1.9% non-white Hispanic and 2.6% others), and the white population consisted of non-Hispanic whites.

The initial results show that several of the variables were different between the BMI categories - gender, histories of congestive heart failure and diabetes, as well as blood pressure measurements and HbA1c. Good outcome discharge disposition differed significantly across BMI categories. Overall comparison of the white and non-white populations showed age, admission systolic blood pressure, anticoagulant use and ICH location were significantly different between the groups. The difference on outcomes where comparisons were performed within each race group was unexpected.

"In the study group, non-white patients with obesity fared worse than non-white patients without obesity," notes Dr. Iwuchukwu. "A similar finding was not observed in white patients with obesity."

Obesity is an established risk factor for cardiovascular disease including acute cerebrovascular disease - acute ischemic and hemorrhagic strokes. Conversely, several previous reports indicated obesity is associated with better outcomes following several acute conditions - heart failure, carotid endarterectomy, sepsis, bypass surgery and vascular surgery. This phenomenon is known as the "obesity paradox."

"Our findings are important as a previous study on outcomes of 'patients with obesity' following (intracerebral hemorrhage) suggested that obesity was associated with improved outcomes," Iwuchukwu added. "Importantly, our study differs as our study population included a large African-American population compared to the prior study, which was primarily an Asian population in South Korea. Our study is significant because epidemiologically, ICH is a common type of stroke amongst 30-50 year old African-Americans, and obesity was an independent predictor of outcomes in our study cohort."

Stroke is the fifth leading cause of death in the United States and is a leading cause of chronic disability. According to the Centers for Disease Control and Prevention (CDC), African-Americans are at greater risk of having a stroke. Compared to whites, they are twice as likely to have a stroke, have strokes at younger ages, and are more likely to have more severe strokes or die from them.

"This is the first study to report poor health outcomes following stroke in predominantly African-American versus Caucasian patients with obesity," concludes senior author Dr. Melinda Sothern, Professor and Jim Finks Endowed Chair in Health Promotion at LSU Health New Orleans School of Public Health. "Patients without obesity were less likely to need rehabilitation and more likely to return home following a stroke event. Findings highlight the need to address the nutritional needs of minority populations at high risk for cardiovascular disease in order to reduce the burden of on recovery following ."

Explore further: Asian-American ethnicity associated with severe stroke, worse outcomes

More information: I. Iwuchukwu et al, Racial differences in intracerebral haemorrhage outcomes in patients with obesity, Obesity Science & Practice (2018). DOI: 10.1002/osp4.167

Related Stories

Asian-American ethnicity associated with severe stroke, worse outcomes

January 25, 2018
Asian Americans were more likely to experience a severe ischemic stroke and have worse outcomes than whites, according to preliminary research presented at the American Stroke Association's International Stroke Conference ...

Deadliest type of stroke seeing surge of new research

March 9, 2018
Patricia Nelson was leaving a restaurant after dinner last June with friends when she started hearing wind blowing in her ear before she'd even stepped outside. "I just didn't feel right," says Nelson, a stroke rehabilitation ...

Heart attack patients prescribed antidepressants have worse one-year survival

March 4, 2018
Heart attack patients prescribed antidepressants have lower one-year survival rates, according to research presented today at Acute Cardiovascular Care 2018, a European Society of Cardiology congress.1

Technology to drive advances in obesity-related diseases

December 11, 2017
For the first time, researchers led by Frank Lau, MD, Assistant Professor of Clinical Surgery at LSU Health New Orleans, have successfully kept white fat tissue alive outside of the body for up to eight weeks. This breakthrough ...

African Americans live shorter lives due to heart disease and stroke

October 23, 2017
The average lifespan of African Americans is significantly shorter than white Americans, mostly because of heart disease and stroke, which contributed to more than two million years of life lost among African Americans between ...

Abdominal obesity linked to all-cause mortality in HFpEF

November 28, 2017
(HealthDay)—For patients with heart failure with preserved ejection fraction (HFpEF), abdominal obesity is associated with increased risk of all-cause mortality, according to a study published in the Dec. 5 issue of the ...

Recommended for you

New link found between alcohol, genes and heart failure

May 25, 2018
The researchers investigated faulty versions of a gene called titin which are carried by one in 100 people or 600,000 people in the UK.

Study examines the rise of plaque in arteries

May 25, 2018
The accumulation of cholesterol plaques in artery walls can lead to atherosclerosis, or the hardening of arteries that contributes to heart attacks and strokes. In a new study, Yale researchers investigate how plaque cells ...

Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition

May 25, 2018
A daily dose of aspirin could help pregnant women in the first stage of high blood pressure avoid a condition that puts both mother and baby in danger, according to a new study.

Antidepressant use may contribute to long-term population weight gain

May 24, 2018
Researchers at King's College London have found that patients prescribed any of the 12 most commonly used antidepressants were 21% more likely to experience an episode of gain weight than those not taking the drugs, (after ...

Study shows in-home therapy effective for stroke rehabilitation

May 24, 2018
In-home rehabilitation, using a telehealth system and supervised by licensed occupational/physical therapists, is an effective means of improving arm motor status in stroke survivors, according to findings presented by University ...

Bid to beat obesity focuses on fat that keeps us warm

May 24, 2018
A new technique to study fat stores in the body could aid efforts to find treatments to tackle obesity.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.