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Call For Improvement In Managing Modifiable Risk Factors For Prevention Of Recurrent Stroke
A DGReview of :"How Well Are Hypertension, Hyperlipidemia, Diabetes, and Smoking Managed After a Stroke or Transient Ischemic Attack?"
Stroke
06/18/2002
By David Ball
Marked improvement in the management of risk factors like hypertension, hyperlipidemia, diabetes and smoking is needed for secondary prevention of stroke, say Canadian researchers.
"Stroke prevention clinics (SPCs) may need to be more actively involved in the management of these modifiable risk factors, if we are to significantly impact the risk of recurrent stroke," according to researchers in specialist departments at the University of Alberta, Edmonton, Canada.
While SPCs are not normally involved in their active management, the benefits of addressing these four risk factors are becoming better understood. However, there have been few long-term follow-up of studies and the effect of SPC generated discussions about these stroke risk factors have not been well described.
This prospective study involved 119 consecutive patients referred to an SPC for secondary prevention. Assessment was made of the proportion of improvement in these patients who were re-evaluated one year after baseline visit on how adequately the risk factors were managed.
Of 112 subjects who returned for the one year follow-up, 66 were male and the average age was 65 years.
Eighty patients were found to have multiple risk factors, hyperlipidemia was found to be present in 92 hypertension in 83, diabetes in 26, and smoking in 38.
Management of these subjects' risk factors was adequate at baseline in 66 percent of those with hypertension, 17 percent of those with hyperlipidemia, and 23 percent of diabetics.
Management of hypertension during one year of follow-up improved 20 percent and lipid management improved 32 percent.
No significant improvement was seen in management of diabetes or smoking cessation.
Stroke. 2002;33:1656.
"How Well Are Hypertension, Hyperlipidemia, Diabetes, and Smoking Managed After a Stroke or Transient Ischemic Attack?"
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