Cardiovascular-Related Death Is More Likely Among Black Adults Born in the United States

Preliminary research results show that immigrants from Africa have lower rates of CVD and stroke.

Black adults born in the United States had a higher rate of death from cardiovascular disease (CVD) and all causes compared with Black adults who were born in other countries, according to preliminary research results to be presented at the American Stroke Association’s International Stoke Conference February 8 to 1, 2022.

Black adults in the United States are at a higher risk for heart attack, stroke, and other CVDs compared with white Americans. However, the risk of death from stroke and other types of CVD, as well as all causes of death, may vary among Black adults born in the United States versus everywhere else.

This study is 1 of the first large, population-based epidemiological studies to examine the impact of migration and assimilation on death among Black individuals, investigators said in a statement.

“How region of origin and acculturation affect death from CVD, stroke, and all causes among Black immigrants remains largely unknown and may provide valuable information for studies on stroke prevention and outcomes for the public, health care professionals, and health care stakeholders,” Alain Lekoubou Looti, MD, an assistant professor of neurology and public health sciences at Penn State College of Medicine at Penn State Health Milton S. Hershey Medical Center, said in a statement.

In the study, investigators evaluated the association between country of birth and stroke prevalence using health information on more than 64,700 Black individuals in the United States, aged 25 to 74 years, from the CDC’s National Health Interview Service data between 2000 and 2014.

Among the individuals who reported surviving a stroke, investigators compared overall death rates, as well as death rates specifically because of CVD and stroke, among Black adults born in the United States and those born in Africa, the Caribbean, and Central and South America.

Additionally, investigators also analyzed the potential effect of time since migration on these parameters.

Of the individuals studied, 2549 had a self-reported history of stroke. There were a total of 4329 deaths, including 932 from CVD and 205 attributable to a stroke recorded during the study period.

When compared with Black adults born in the United States, African-born Black adults who reported having had a stroke had a 50% rate lower death from all causes and trended toward having lower cardiovascular death rates.

At the 10-year follow-up, the incidence of death for US-born Black individuals from all causes was 12.6%, with 2.76% from CVD and 0.6% from stoke. Among Black individuals who were born in the Caribbean and Central and South America, the incidence of death from all causes was about 6.1%, with 1.6% and 0.45% from CVD and stroke, respectively.

Additionally, for Black individuals born in Africa, the incidence of death from all causes was 3.15%, with 0.54% from CVD and 0.08% from stroke.

Compared with US-born Black adults, the rates of death among Black individuals born in the Caribbean and Central and South America from all causes were about 54% lower and about 40% lower from CVD, respectively. However, rates of death from stroke were similar.

Time since migration did not significantly affect death rates among Black individuals born outside the United States.

A potential study limitation is that stroke was self-reported by participants.


Death due to cardiovascular disease more likely among Black adults born in the US. EurekAlert. News release. February 3, 2022. Accessed February 3, 2022.

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