Common Stroke Drug May Not Help African-American Women: Researcher

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- Every 40 seconds, someone in this country has a stroke. African American women are the hardest hit when it comes to these deadly brain attacks.

Black women are twice as likely to have a stroke and much less likely to survive one than white women. But, at Morehouse School of Medicine one stroke researchers says the "gold standard" stroke treatment, tPA, may not work as well for African American women.

Mary Carter is a stroke survivor.  On April 6, 2015, she says her head was killing her, her arm felt weak, and her blood pressure was crazy high.  "Normal" blood pressure is 120/80 or lower.

"It was (well) over 200/100," Carter says.

The 62-year old retired BellSouth customer service rep says she went to a drugstore clinic to see a nurse.

"She told me I had a sinus infection," Carter says. "She prescribed me some medicine and sent me home."

The next morning, Carter says she woke up disoriented.

"I got up, I couldn't walk, I just fell down," she says.  "I thought I was getting ready to die."

Paramedics rushed Mary, who was having a stroke, to the emergency room.   But, it was too late for her to safely be given the clot-busting drug tPA, or tissue plasminogen activator.  It's the "gold standard" emergency treatment for a stroke caused by a blood clot. It typically has to be given in the first three hours of a stroke.

In Carter's case, she was hours into the stroke, and the damage was done. She spent 5 days in the ICU, and nearly a month in a rehabilitation hospital.

But, here's the thing.  Morehouse School of Medicine's Dr. Roger Simon, Professor of Medicine and Neurobiology, and his colleagues found something surprising about tPA.

"It was a real eye opener," says Dr. Simon.

Using already published data, the researchers compared how men and women of different races responded to tPA, compared to a placebo or sugar pill.

Dr. Simon says both white men and women did pretty much equally well on tPA. African American men a little less of a response, but the drug was still pretty effective in stopping their strokes.

"But the amazing thing was in the African American women, it had no effect," says Simon.

"It wasn't that there was less effect, or an attenuated effect.  There was no effect at all."

Dr. Simon says more research is needed - to determine what this means for African American women.

Until then, he says a better option for Black women may be a thrombectomy. That's a minimally invasive procedure in which doctors mechanically remove a blood clot from the brain to restore blood flow to the damaged tissue. Over the last few years, this approach has become more common. But, the procedure is still relatively new, and is only available at major stroke centers like Grady Memorial Hospital.

So, what should Black women do if they suspect they may be having a stroke?  First, call 9-1-1.

"If she got to the hospital and had two choices: one is mechanical removal and the other is PA, there is no doubt, in an African American woman which way to go," says Dr. Simon. "You go with the mechanical (approach)."

Mary Carter is doing well.  She says she wishes she had known the warning signs of a stroke.  She believes it would have made a huge difference.

To remember the signs of stroke, she says, think of the word FAST:

  • F: facial drooping
  • A: arm weakness
  • S: speech difficulty
  • T: time to call 911.

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