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Risk factor control after ischemic stroke or transient ischemic attack.

Nanxiang Ouyang1, Chuning Shi1, Xiaofan Guo1

  • 1Department of Cardiology, The First Hospital of China Medical University, Shenyang, China.

Acta Neurologica Scandinavica
|February 2, 2021
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Summary

Improving risk factor control after ischemic stroke or transient ischemic attack (IS/TIA) is crucial in rural China. Uncontrolled blood pressure and lack of physical activity significantly increase recurrent stroke risk.

Keywords:
ischemic strokerecurrent strokerisk factorsecondary preventiontransient ischemic attack

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Area of Science:

  • Cardiovascular epidemiology
  • Public health research
  • Stroke prevention

Background:

  • Ischemic stroke (IS) and transient ischemic attack (TIA) pose significant public health challenges.
  • Effective management of modifiable risk factors is key to preventing recurrent events.
  • Data on risk factor control and recurrence in rural Chinese populations are limited.

Purpose of the Study:

  • To assess the control status of key risk factors post-IS/TIA in rural northeastern China.
  • To determine the impact of uncontrolled risk factors on the incidence of recurrent stroke.

Main Methods:

  • A population-based prospective cohort study involving adults aged ≥35 years in rural northeastern China.
  • Baseline cardiovascular health examinations (2012-2015) and follow-up for cardiovascular events until 2018.
  • Cox proportional hazard models were employed to analyze the association between risk factor control and stroke recurrence.

Main Results:

  • Among 575 IS/TIA patients, risk factor control varied: 81.6% for fasting plasma glucose (FPG), 65.7% for smoking cessation, and 61% for physical activity.
  • Blood pressure (BP), LDL-cholesterol (LDL-C), and BMI control were poor (28.3%, 26.3%, 37.4%).
  • Recurrent stroke occurred in 12% of patients over a median follow-up of 4.43 years. Uncontrolled BP (HR: 2.081) and insufficient physical activity (HR: 1.685) significantly increased recurrence risk.

Conclusions:

  • Risk factor management following IS/TIA requires substantial improvement in rural northeastern China.
  • Targeting BP control and promoting physical activity are critical interventions to reduce stroke recurrence.
  • Enhanced post-stroke care can mitigate the public health and economic burden of stroke in these communities.