Eur Stroke J
ESOC 2026: Stroke gains reversed as disparities widen across ethnic and socioeconomic lines
Clinical takeaway: Intensify early cardiovascular risk screening and management—particularly hypertension and diabetes—in ethnic minority and socioeconomically disadvantaged patients, who face earlier onset and markedly higher stroke risk.
Improvements in stroke prevention may be stalling—and even reversing—in the very populations at highest risk, underscoring gaps in screening, prevention, and access to care.
A 30-year population-based analysis from the South London Stroke Register suggests that decades of declining stroke incidence may be reversing, with widening disparities across ethnic and socioeconomic groups. The study included 7,726 first-ever strokes in a population of about 333,000 residents.
After falling 34% from 198 to 131 cases per 100,000 between 1995–1999 and 2010–2014, stroke incidence rose by 13% in 2020–2024. Notably, this increase wasn’t evenly distributed: rates remained relatively stable in White populations but rose sharply in ethnic minority groups.
By 2020–2024, stroke incidence was more than twice as high in Black African (incidence rate ratio [IRR], 2.31; 95% confidence interval [CI], 2.03–2.62) and Black Caribbean (IRR, 2.00; 95% CI, 1.73–2.31) populations compared with White counterparts. Disparities were most pronounced among individuals living in the most deprived areas and for severe stroke subtypes such as intracerebral hemorrhage.
Risk factor burden was also higher among minority groups, with substantially greater prevalence of hypertension (up to 47% higher) and diabetes (up to 123% higher). Alarmingly, 12% of Black African patients had no documented risk factors prior to stroke vs. 6.3% of White patients, suggesting missed opportunities for early detection.
“Current prevention programs are not reaching these groups,” said lead researcher Dr. Camila Pantoja-Ruiz, who emphasized the need for targeted screening and earlier intervention.
The findings suggest that structural factors—including access to care, socioeconomic deprivation, and potential gaps in risk-factor control—are driving unequal progress in stroke prevention, with some populations experiencing stroke up to a decade earlier than others.
Study results were presented at presented at the European Stroke Organisation Conference (ESOC) 2026.
Source: Pantoja-Ruiz C, et al. (2026, May 6). Eur Stroke J. ABSTRACT NUMBER: ESOC2026A1502 Widening Ethnic Inequalities In Stroke Incidence: A 30-Year Population-Based Analysis Of The South London Stroke Register