Little Change of Modifiable Risk Factors 1 Year after Stroke: a Pilot Study

Abstract

Background Recurrent stroke accounts for about 25% of admissions for acute stroke. For the prevention of recurrent cerebro and cardiovascular disease, stroke patients are advised to change modifiable stroke risk factors before discharge from stroke units. Aims To investigate the change in modifiable risk factors 1 year after stroke and to explore the feasibility of a preventive programme aimed at stroke patients discharged from hospital. Methods From April 2004 to February 2005, 173 patients admitted to hospital with a diagnosis of stroke were consecutively included and interviewed about their medical history and modifiable risk factors before stroke. One-year follow-up with measurement of blood pressure was performed in 92% of surviving and able participants. Results One year after discharge, 121 participants were reinterviewed and 118 had their blood pressure measured. We found uncontrolled hypertension in 43 of 65 patients (66% of those receiving antihypertensive medication) and unknown hypertension in 30 of 53 patients (57% of those without antihypertensive medication). There was a reduction in the prevalence of excessive consumption of alcohol from 24 of 121 patients (20%) to 16 of 121 patients (13%) (P<005). The frequency of cigarette intake remained unchanged: 57 of 121 patients (47%) 1 year after stroke. The proportion of patients who were physically inactive increased from 36% (43 of 121 patients) before stroke to 59% (71 of 121) 1 year later ( P < 0·0001). Conclusions The change in modifiable risk factors was inadequate 1 year after stroke. The pilot study indicated that a preventive programme should focus on hypertension, smoking and physical inactivity.