J Hypertens 2015 Oct;33(10):2107-14
aCenter for Cardiovascular Prevention, First Medical School of Charles University in Prague and Thomayer Hospital, Prague bSecond Department of Internal Medicine, Charles University Medical Faculty and Teaching Hospital cBiomedical Center, Medical Faculty of Charles University, Pilsen dDepartment of Neurology, Thomayer Hospital, Prague eDepartment of Neurosurgery and Department of Neurology, University Hospital, Pilsen fMedical Statistics Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Objective: Recurrent strokes are associated with higher mortality, greater disability, and increased healthcare costs compared with first-ever stroke. Lifestyle measures and drug treatment in secondary prevention decrease the risk of recurrence while improving the quality of life of patients. The objective of this study was to determine the prevalence of hypertension and other cardiovascular risk factors in stroke survivors and population controls.
Methods And Results: A total of 424 poststroke survivors (aged 66.0 ± 10.4 years) were examined 6-36 months after their first ischemic stroke. Controls of similar age and from the same geographic region were selected from the database of the Czech post-Multinational MONItoring of trends and determinants in CArdiovascular disease Study. Hypertension was found to be the most prevalent risk factor affecting 91.5% of stroke survivors and 71.8% of controls. Use of antihypertensive drugs was reported in 79.5% of stroke survivors and 56.7% of controls. However, blood pressure lower than 140/90 mmHg was achieved in only 49.5% of hypertensive stroke survivors. More than 60% of stroke survivors used statins but low-density lipoprotein-cholesterol lower than 2.5 mmol/l was achieved in only 47.4 and 37% of male and female poststroke survivors, respectively. About a third of poststroke patients continue to smoke, and obesity is a major problem, particularly in women (prevalence 47%), who also have a high prevalence of diabetes.
Conclusion: We found a high prevalence and poor control of major cardiovascular risk factors in patients surviving their first-ever ischemic stroke, thus showing poor implementation of guidelines for secondary prevention in clinical practice.