Changes in risk factor profile after ischemic stroke

Background and aims. Adherence to preventive medication and to a healthy life style reduces stroke survivors’ risk of recurrent stroke. We investigated risk factor management in patients admitted to 3 Copenhagen hospitals with ischemic stroke (IS)

Methods. 320 patients with acute IS were followed up 1 year after stroke. We constructed a baseline risk factor profile (RFP) of 6 variables: smoking, excessive drinking, physical inactivity, untreated hypertension, no cholesterol-lowering, and no antithrombotic treatment/warfarin at discharge from hospital. Each item was rated 0 or 1 giving a maximum score of 6 points. Mean baseline RFP-score was 1.6

Results. After 1 year we found a reduction in current smoking (p=0.008) and in excessive drinking (p=0.0001). There was no change in physical activity and in untreated hypertension. There was an increase in the proportion of patients on lipid-lowering (p=0.011) and antithrombotic (p=0.0003) treatment yielding a reduction in RFP to 1.4 (p<0.0001). Still, the majority of patients were hypertensive, and most patients with untreated hypertension and hypercholesterolemia remained untreated.

By 1-year follow up 30 patients (9.4%) had had a non-fatal recurrent stroke or myocardial infarction

Conclusions. We suggest the organisation of secondary prevention clinics within the stroke units for life style modification and treatment to target of risk factors immediately after discharge, thus extending the success of TIA clinics to all stroke survivors