Advanced

Long-Term Stroke Prognosis in Relation to Medical Prevention and Lifestyle Factors. A Prospective Population-Based Study.

Li, Cairu LU ; Engström, Gunnar LU ; Janzon, Lars LU and Hedblad, Bo LU (2008) In Cerebrovascular Diseases 25(6). p.526-532
Abstract
Background: Few studies have focused on the quality of secondary prevention among long-term stroke survivors. This study explores the intensity of medical intervention and the impact of lifestyle and other risk factors on the long-term stroke prognosis in a population-based setting of Swedish individuals with a history of stroke. Methods: A population-based cohort (n = 28,449) in Malmo, Sweden, was recruited during 1991-1996. Of them, 394 had a history of stroke, according to self-reported physician diagnosis and record linkage with the Stroke Register in Malmo. Information on medical intervention and lifestyle factors was collected from the questionnaire. The incidence of a cardiac event (CE) or recurrent stroke was followed for 7.5 years... (More)
Background: Few studies have focused on the quality of secondary prevention among long-term stroke survivors. This study explores the intensity of medical intervention and the impact of lifestyle and other risk factors on the long-term stroke prognosis in a population-based setting of Swedish individuals with a history of stroke. Methods: A population-based cohort (n = 28,449) in Malmo, Sweden, was recruited during 1991-1996. Of them, 394 had a history of stroke, according to self-reported physician diagnosis and record linkage with the Stroke Register in Malmo. Information on medical intervention and lifestyle factors was collected from the questionnaire. The incidence of a cardiac event (CE) or recurrent stroke was followed for 7.5 years after the baseline examination. Results: The prevalence of hypertension was 79.4% in patients with a history of stroke. Only half of them received blood-pressure (BP)-lowering medication, and 11.5% of them achieved a BP <140/90 mm Hg. Most patients with hypercholesterolemia did not receive lipid-lowering medication. Antithrombotic agents were used by 38%. Nearly one third were still smoking, and two thirds were overweight or obese. Compared to subjects without a history of stroke, the risk of cardiovascular disease (CVD, i.e. CE or recurrent stroke) was significantly higher in stroke survivors. The increased CVD risk was significantly associated with elevated BP levels. No significant relationship was found between CVD risk and lifestyle risk factors reported at the time of baseline examination. Conclusions: There was a large gap between recommended secondary preventive measures and their implementation in subjects with a history of stroke. Achieving recommended hypertension control may prevent a substantial proportion of the CE and recurrent strokes in this group. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cerebrovascular Diseases
volume
25
issue
6
pages
526 - 532
publisher
Karger
external identifiers
  • wos:000257479700003
  • pmid:18480605
  • scopus:45549086616
ISSN
1421-9786
DOI
10.1159/000131670
language
English
LU publication?
yes
id
cf29c2be-e95c-4f23-b1bd-976a33853d45 (old id 1154122)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18480605?dopt=Abstract
date added to LUP
2008-06-05 10:16:41
date last changed
2017-01-01 05:11:11
@article{cf29c2be-e95c-4f23-b1bd-976a33853d45,
  abstract     = {Background: Few studies have focused on the quality of secondary prevention among long-term stroke survivors. This study explores the intensity of medical intervention and the impact of lifestyle and other risk factors on the long-term stroke prognosis in a population-based setting of Swedish individuals with a history of stroke. Methods: A population-based cohort (n = 28,449) in Malmo, Sweden, was recruited during 1991-1996. Of them, 394 had a history of stroke, according to self-reported physician diagnosis and record linkage with the Stroke Register in Malmo. Information on medical intervention and lifestyle factors was collected from the questionnaire. The incidence of a cardiac event (CE) or recurrent stroke was followed for 7.5 years after the baseline examination. Results: The prevalence of hypertension was 79.4% in patients with a history of stroke. Only half of them received blood-pressure (BP)-lowering medication, and 11.5% of them achieved a BP &lt;140/90 mm Hg. Most patients with hypercholesterolemia did not receive lipid-lowering medication. Antithrombotic agents were used by 38%. Nearly one third were still smoking, and two thirds were overweight or obese. Compared to subjects without a history of stroke, the risk of cardiovascular disease (CVD, i.e. CE or recurrent stroke) was significantly higher in stroke survivors. The increased CVD risk was significantly associated with elevated BP levels. No significant relationship was found between CVD risk and lifestyle risk factors reported at the time of baseline examination. Conclusions: There was a large gap between recommended secondary preventive measures and their implementation in subjects with a history of stroke. Achieving recommended hypertension control may prevent a substantial proportion of the CE and recurrent strokes in this group.},
  author       = {Li, Cairu and Engström, Gunnar and Janzon, Lars and Hedblad, Bo},
  issn         = {1421-9786},
  language     = {eng},
  number       = {6},
  pages        = {526--532},
  publisher    = {Karger},
  series       = {Cerebrovascular Diseases},
  title        = {Long-Term Stroke Prognosis in Relation to Medical Prevention and Lifestyle Factors. A Prospective Population-Based Study.},
  url          = {http://dx.doi.org/10.1159/000131670},
  volume       = {25},
  year         = {2008},
}