Modification of risk factors after cerebral infarct: results of the Klosterneuburg Stroke Databank
Dachenhausen, A.; Brainin, M.; Steiner, M.
Wiener Medizinische Wochenschrift 147(2): 41-45
1997
ISSN/ISBN: 0043-5341 PMID: 9139471 Document Number: 475114
A number of studies have shown that reduction of elevated blood pressure and other major risk factors are essential for the primary prevention of stroke. In contrast, only sparce data exist as to the reduction of risk factors in secondary prevention although many patients are only ready to modify their lifestyle after having suffered a stroke. This study reports the results of the one-year follow-up examinations from the Klosterneuburg Stroke Data Bank, a prospective, hospital-based registry. Out of 870 stroke survivors (97.4% follow-up rate) registered between 1988 and 1994 575 patients (69%) had been hypertensive before their index stroke. Out of these, 112 hypertensives (19.7% of all hypertensives) had not received antihypertensive treatment before their index stroke. Compared to all other hypertensive stroke patients they were significantly younger (p = 0.01), more often regular drinkers (p = 0.01), and regular smokers (p = 0.007). They showed significantly less heart diseases (p = 0.03) as well as prior strokes (p = 0.006). 12 months after the index-stroke the rate of untreated hypertension in this group fell to 6.0% (34 patients). In the latter group there were more frequent prior strokes compared to those hypertensives who started regular treatment after their index stroke (p = 0.003). Out of 221 smokers only 115 (52%) had quit smoking within one year after the index-stroke and 110 out of 270 (40.7%) stroke patients that had had regular alcohol intake had stopped drinking. 42 out of 118 (36%) patients who had been regular drinkers and smokers continued to drink and smoke. Regular intake of aspirin was noted more often in those patients who also had regular blood pressure checks (p = 0.009) and regular antihypertensive treatment (p = 0.001). It is concluded that there is insufficient modification of risk factors after stroke and controlled interventional studies in secondary stroke prevention are an important issue.