December 19, 2012

Nation’s largest racial disparities stroke study at UAB awarded $28M renewal grant

Written by
The University of Alabama at Birmingham has been awarded a $28 million grant renewal for the nation’s largest study aimed at exploring racial and geographic differences in stroke illness and stroke death from The National Institute for Neurological Disorders and Stroke.

The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study enrolled 30,239 people ages 45 and older between January 2003 and October 2007, and it continues to follow them for health changes.

Petra Kaufmann, M.D., the associate director of clinical research at NINDS, said stroke is the fourth leading cause of death in the United States, and blacks are disproportionately affected more than whites. 

“The REGARDS study is important because it examines the potential reasons for this health disparity, and the continued follow-up of the more than 30,000 participants will strengthen the study,” Kaufmann explained. “We are looking forward to the next stage, where we can begin to turn some of this research into much-needed interventions to improve stroke prevention and outcomes, as well as to foster health equity.” 

Previous findings from REGARDS included that blacks are three times more likely than whites to have a stroke, and that half of the racial disparity is explained by traditional risk factors. According to the study’s principal investigator, George Howard, Dr.P.H., professor in the Department of Biostatistics in the UAB School of Public Health, the funding renewal will enable REGARDS to examine the other half of reasons for the sharp contrast in risk by investigating several theories as to why there are racial differences in stroke.

“The exciting thing is we have had 12 years of what we consider to be solid success in moving the envelope forward in understanding why disparities in stroke exist, and now we can continue down the road on which we started,” Howard said.

One of the study’s lead investigators, Virginia Howard, Ph.D., said the overarching goal of the project is to provide information to guide the development of interventions and reduce these disparities in stroke risk.

“We want to provide information for policymakers to use at the state and national levels; the information from REGARDS allows people to take it and say, ‘We’ve learned this, so how can we transform this into an intervention in our community?’” said Howard, a professor in the UAB Department of Epidemiology.

UAB Interim President Richard Marchase, Ph.D., echoed the importance of REGARDS, the largest population-based investigation of its kind, in advancing the medical community’s understanding of stroke disparities along racial and geographic lines.

“Identifying where and why stroke incidence is higher is key to developing the most effective prevention and treatment strategies and, ultimately, improving health and quality of life for millions of Americans,” Marchase said. “UAB is very excited and grateful that funding for REGARDS, this groundbreaking national study which over the years has been and will be responsible for more than $100 million of grant activity on campus, will continue.”

UAB School of Public Health Dean Max Michael, M.D., agreed.

“This remarkable nationwide study of stroke continues to expand our understanding about the causes of this disease, as well as dispel common myths,” Michael said. “What Dr. Howard and his team have built over the last 10 years is indeed a national treasure, and its value will only continue to increase.”

“The cost of stroke disparities is $6.4 billion annually,” Howard said. “If we could reduce the disparity by only 5 percent, which we consider modest, we would save $320 million annually. If we achieve that reduction, the entire cost of the five-year study would be paid for in just 32 days of savings.”

In addition to its contributions to the understanding of stroke, REGARDS has offered insights into heart disease, venous thrombosis and occupational exposures. Howard described the study as a wealth of information for others to utilize. REGARDS has more than 20 funded ancillary studies.

REGARDS is a research partnership that includes UAB’s departments of Epidemiology and Biostatistics, the Division of Gerontology, Geriatrics, and Palliative Care, the Division of Preventive Medicine, UAB’s Center for Aging and Center for the Study of Community Health, the University of Vermont in Burlington, the University of Arkansas for Medical Sciences in Little Rock, the University of Cincinnati, Indiana University in Indianapolis and Wake Forest University School of Medicine in Winston-Salem, N.C.