Stroke services have been made a priority in recent years
Stroke death rates are three times higher in the poorest areas of England and Wales, a study has shown.
The audit of death figures found there were 29 deaths per 100,000 men under 65 each year in the poorest areas compared with just eight in the wealthiest.
For women, the gap was less at 17 per 100,000 in the most deprived and six in the least, the British Heart Foundation and Stroke Association found.
The groups said more needed to be done to tackle the "shocking" difference.
The two charities used death rates broken down by local authority areas to compare the least deprived 5% with the most deprived.
The audit did not set out firm reasons for the differences in death rates, although it is thought to be linked to lifestyle and access to services.
BHF medical director Professor Peter Weissberg said: "The figures argue for a concerted effort to identify and modify risk factors by lifestyle and drug interventions in those communities with the highest risks.
"We don't underestimate the challenge this poses, but success will save the lives of thousands of people and prevent disability in many more."
Joe Korner of the Stroke Association agreed. He said the statistics were "shocking", adding: "Decreasing inequalities in our society will also lessen inequalities in health outcomes."
The government has already made improving stroke care a priority in recent years.
A national strategy was launched in England in 2007 aimed at giving people earlier access to diagnostic scans and treatment.
Similar schemes have been set out elsewhere in the UK as stroke is the third biggest killer in the country - behind cancer and heart disease - responsible for 50,000 deaths a year.
The Department of Health said as part of the stroke strategy local networks of experts were being put in place charged with tackling this issue.
A spokesman added: "The last 10 years have seen great progress in stroke - more patients than ever before are being seen by stroke specialists and advancing medical understanding gives every prospect for a real revolution in stroke treatment over the next few years."