Journal of Stroke & Cerebrovascular Diseases
Volume 19, Issue 4 , Pages 311-320, July 2010

Awareness, Treatment, and Control of Vascular Risk Factors among Stroke Survivors

  • David A. Brenner, MD

      Affiliations

    • Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Mobile, Alabama
    • Alabama Neurological Institute, Birmingham, Mobile, Alabama
    • Corresponding Author InformationAddress correspondence to David A. Brenner, MD, Department of Neurology, Alabama Neurological Institute, 513 Brookwood Blvd, Suite 405, Birmingham, AL 35209.
    • ,
  • Rich M. Zweifler, MD

      Affiliations

    • Department of Neurology, University of South Alabama, Birmingham, Mobile, Alabama
    • ,
  • Camilo R. Gomez, MD, MBA

      Affiliations

    • Alabama Neurological Institute, Birmingham, Mobile, Alabama
    • ,
  • Brett M. Kissela, MD

      Affiliations

    • Department of Neurology, University of Cincinnati, Tucson
    • ,
  • Deborah Levine, MD

      Affiliations

    • College of Public Health, The Ohio State University Columbus, Ohio, Tucson
    • ,
  • George Howard, DrPH

      Affiliations

    • Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, Mobile, Alabama
    • ,
  • Bruce Coull, MD

      Affiliations

    • Department of Neurology, The University of Arizona, Tucson
    • ,
  • Virginia J. Howard, PhD

      Affiliations

    • Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Mobile, Alabama

Received 6 April 2009; received in revised form 16 June 2009; accepted 1 July 2009. published online 17 May 2010.

Introduction

Stroke survivors should recognize and control vascular risk factors to prevent recurrent strokes. We therefore assessed the prevalence, treatment, and control of hypertension, diabetes, and dyslipidemia among stroke survivors versus stroke-free control subjects.

Methods

We conducted cross-sectional analysis from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study cohort, which includes oversampling from the Stroke Belt and African Americans. Patients were interviewed by telephone then visited for blood pressure, glucose, and lipid measurements. There were 2830 participants reporting a past stroke or transient ischemic attack (TIA) (stroke survivors) and 24,886 participants without past stroke or TIA (control subjects). Outcome measures included the recognition, treatment, and control of hypertension, diabetes, and dyslipidemia.

Results

Stroke survivors were more likely to have unrecognized hypertension (18.7% v 13.5%, P < .0003), unrecognized stage 2 hypertension (4.4% v 2.2%, P < .0006), and unrecognized diabetes (4.2% v 3.2%, P < .026) versus control subjects. Stroke survivors were more likely to be treated for hypertension (92.4% v 89.0%, P < .0001), diabetes (88.3% v 81.4%, P < .0001), and dyslipidemia (76.3% v 61.9%, P < .0001). However, despite treatment, stroke survivors were more likely to have hypertension (33.3% v 30.4%, P=.0074) and stage 2 hypertension (9.1% v 7.6%, P=.017). Predictors of unrecognized and undertreated risk factors in stroke survivors include increasing body mass index, black race, and lower education.

Conclusion

Despite having a past stroke or TIA, stroke survivors had higher rates of unrecognized hypertension, unrecognized diabetes, and undertreated hypertension. Better efforts are needed to help stroke survivors recognize and control vascular risk factors to prevent recurrent stroke.

Key Words: Stroke, epidemiology, vascular risk factors, hypertension, diabetes, secondary stroke prevention

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services. This funding supports the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript.

 There are no conflicts of interest or financial gain from any authors contributing to this manuscript. Dr. George Howard (study principal investigator) had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

 Dr. George Howard performed the statistical analysis.

PII: S1052-3057(09)00130-X

doi:10.1016/j.jstrokecerebrovasdis.2009.07.001

Journal of Stroke & Cerebrovascular Diseases
Volume 19, Issue 4 , Pages 311-320, July 2010

Article Tools