Black Residents in England Face Double Stroke Risk, Get Less Timely Care, Study Finds

People from black backgrounds in England suffer strokes at twice the rate of white people and receive less timely care, the largest study of its kind has found.

Researchers at King’s College London presented the analysis at the European Stroke Organisation conference. It examined 30 years of data from the South London Stroke Register, one of the world’s longest-running population-based stroke registers.

Unlike clinical trials, the register includes every stroke patient in a defined area. Among a population of 333,000, it recorded 7,726 strokes. Incidence dropped 34 percent from 1995-99 to 2010-14, then climbed 13 percent from 2020 to 2024.

During that recent rise, black African and Caribbean people faced more than double the stroke risk of white people. Stroke incidence stood 131 percent higher among black Africans and 100 percent higher among black Caribbeans compared with white counterparts.

Black people also showed up to 47 percent higher odds of high blood pressure and twice the diabetes risk, even after adjustments for socioeconomic factors and other risks.

Dr. Camila Pantoja-Ruiz, lead author from King’s College London, said: “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.”

She added: “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. Compared with other stroke types, intracerebral haemorrhage is more strongly associated with uncontrolled high blood pressure, which is more common in black communities.”

Black African stroke survivors proved 34 percent less likely to get NHS follow-up care. They also experienced strokes 10 to 12 years earlier than white patients.

Researchers noted the post-stroke period proves critical for preventing recurrence, leaving black patients more exposed to poor outcomes. “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,” Pantoja-Ruiz said.

Maeva May, policy director at the Stroke Association, said: “These findings reveal that stroke is rising again and that black African and black Caribbean communities are bearing a disproportionate burden. 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.”

“We know that progress is possible – stroke rates have been falling over the last two decades, proving that prevention works when it reaches the people who need it. 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.”