Secondary prevention and lifestyle indices after stroke in a long-term perspective

ObjectivesTo describe the long-term perspective regarding prevalence of risk factors, secondary stroke prevention, and lifestyle indices after stroke. MethodsFrom a population-based one-year cohort (n=416), we performed an observational study of 145 survivors at 16months and 10years after stroke (age 27-97years) regarding secondary prevention including reaching acceptable treatment goals; nutritional status with focus on underweight; and the lifestyle indices: living situation, level of dependence, and self-assessed health condition. ResultsTen years after stroke, 50% of the subjects with hypertension diagnosis and 55% of those without hypertension diagnosis were within the blood pressure goal <140/90 compared with 32% (P=.008) and 37% (N.S.) at 16months. Acceptable HbA1c levels among subjects with diabetes mellitus diagnosis increased from 35% to 45% (N.S.). Among those without diabetes diagnosis, satisfactory HbA1c levels decreased from 98% to 79% (P<.001). Underweight increased from 9% to 17% (P=.019). Among patients with cerebral infarction, the prevalence of atrial fibrillation increased from 22% to 29% (P=.004), and treatment with oral anticoagulants from 75% to 78% (N.S.). Acceptable LDL cholesterol levels increased from 59% to 80% (P=.033) among subjects on lipid lowering treatment, and from 18% to 40% among untreated (P=.010). At 10years, 90% still lived in their own home. Health condition was reported as good/very good/excellent by 65%. Age, female sex, and living situation were associated with intensity of secondary prevention measures and underweight. ConclusionsThe proportion of individuals within treatment goals improved over time, but secondary prevention still needed additional consideration 10years after stroke.