Compliance with risk factor modification: early-onset versus late-onset stroke patients

To study the compliance to risk factor modifications and factors related to it, which may be different between early-onset (15-45 years) and late-onset (>45 years) stroke patients. These issues have not yet been addressed properly.

We selected 170 early-onset and 340 late-onset stroke patients from the Asan Stroke Registry. The patients were then followed for 1-5 years (an average of 3.4 years) after the onset of stroke. We used a standardized questionnaire to assess the level of compliance and examine the factors contributing to noncompliance.

Ninety-six early-onset and 160 late-onset patients completed a standardized questionnaire. Early-onset patients were less compliant than late-onset patients in the use of antihypertensive medication (p < 0.01), the cessation of cigarette smoking (p < 0.05) and in regular exercise (p < 0.05). Multivariate analysis showed that factors related to noncompliance in early-onset stroke patients included 'a lack of insurance' (noncompliance with the use of antihypertensive medication) and male gender (noncompliance with participation in regular exercise). Factors related to noncompliance in late-onset stroke patients included a high number of cigarettes consumed before the stroke (noncompliance with the cessation of smoking), the lack of regular exercise and a severe modified Rankin scale (noncompliance with regular exercise).

Early-onset stroke patients are generally less compliant than late-onset stroke patients and the factors related to noncompliance in these groups are different. Therefore, strategies should be developed for improving patient compliance, based on these differences.