New York City has a low incidence of strokes compared to the US, but Harlem has the highest rate of stroke in NYC ...

Dr Olajide Williams is a physician at Harlem Hospital and a key leader in stroke treatment and prevention in Harlem.

Q: Why are strokes such a dangerous health issue in Harlem?

A: One American has a stroke every 45 seconds, and every three minutes someone in this country dies from stroke. African Americans have the highest stroke death rates-they are three to four times more likely to suffer stroke than white Americans in the 35-54 age bracket. Yet, African Americans are less likely than any other group to receive or ask for information about stroke.

The local statistics are just as disturbing. New York City has a low incidence of strokes as compared with the national statistics; however, Harlem has the highest rate of stroke in NYC, with Brooklyn and the Bronx following close behind. African Americans die at twice the rate of whites from stroke.

Q: What can people in Harlem do to prevent stroke?

A: Up to 80% of strokes are caused by things like high blood pressure, diabetes and smoking. Poor nutrition and lack of physical activity make people more at risk for abdominal obesity (fat stored around the waist) that is directly linked to stroke.

So, while there are many factors African Americans can't change-like a possible (controversial) underlying genetic propensity toward this disease-they should focus on what they can change. Smoking, for instance, doubles the risk of stroke. When a smoker quits, their risk of stroke drops by 50% and after five years their risk becomes that of a non-smoker.

Q: Who are the people with the most chance of having a stroke?

A: African Americans aged 35 to 54 have the most disparity in stroke risk, although the risk of stroke in everyone doubles every decade after age 55. According to research, heart disease and stroke are the number one killers of African Americans. Key lifestyle risk factors include poor nutrition, tobacco smoking, and lack of adequate physical activity. Mental and environmental factors, such as stress and depression all play a key role as well. The major medical risk factors are high blood pressure, type 2 diabetes, atrial fibrillation, abdominal obesity, and high cholesterol.

To contact Dr. Williams at Harlem Hospital Center, call 212.939.4240 or email him at OWilliams@neuro.columbia.edu.

Harlem Word is a series of interviews with community health experts written by HHPC and reviewed by our Health Advisory Board.