You know that having high blood pressure increases your chance of having a stroke. But did you know that where you live might make a difference? According to new studies reported at the American Stroke Association's recent conference, African-American men in the South have the highest risk of all, while the risk is lowest for white women in New York City.

One study found a general decline in deaths from stroke and huge regional differences in the incidence of strokes. For example, Alabama and Mississippi are no longer in the "Stroke Belt" of the Southeast; the rate remains high in Arkansas, Tennessee, Georgia, and South Carolina. The lowest stroke rates in the country are at the southern tip of Florida, one county in southern New Mexico, and New York City. On the other hand, some counties in the Pacific Northwest and one county in northern Wyoming have very high rates. According to the researchers, the reasons are not understood: "it's a major mystery," they noted.

In another study, researchers also found geographic patterns in the reduction in deaths from stroke. Death rates from stroke after release from the hospital were lower in the Northeast and West, compared to the South and Midwest. This was true even though those in the Northeast were sicker and were in the hospital longer. In this study, which involved more than 55,000 patients in VA medical centers nationwide, those with better outcomes were more likely to have seen their primary care doctor or a neurologist following their hospitalization. Thus follow-up care seems to play an important role.