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Updated: Jun 21, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Investigation of vascular risk factor control and secondary prevention medication compliance in acute ischemic stroke
Yun Chen1, Yuan Zhang1, Lianyan Jiang2
1Zhejiang Provincial People's Hospital Bijie Hospital, Bijie, China.
Insights
Medication compliance for vascular risk factors after ischemic stroke is low, impacting control rates. Improving adherence to secondary prevention is crucial for effective risk management and preventing future events.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Vascular risk factor management is critical for secondary prevention after ischemic stroke.
- Understanding factors influencing control of blood pressure, lipids, and glucose is essential.
Purpose of the Study:
- To investigate the management and control of vascular risk factors in ischemic stroke patients.
- To identify factors affecting the control of blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and glycated hemoglobin (HbA1c).
- To assess medication compliance over 12 months post-stroke.
Main Methods:
- Analysis of clinical data from 1,572 ischemic stroke patients.
- Assessment of BP, LDL-C, and HbA1c control thresholds.
- Longitudinal follow-up of medication compliance at 3, 6, and 12 months.
- Logistic regression analysis to adjust for confounding factors.
Main Results:
- Control targets for BP, LDL-C, and HbA1c were achieved in approximately 50% of patients.
- Age, ethnic minority status, coronary heart disease, prior stroke history, and alcohol consumption influenced BP and lipid control.
- Lifestyle modifications positively correlated with BP, glucose, and lipid control.
- Absence of regular physical activity was linked to poorer glycemic and lipid control.
- Overall medication compliance declined over time.
Conclusions:
- Medication compliance for vascular risk factors in ischemic stroke patients is unsatisfactory.
- Enhancing compliance with secondary prevention medications is key to improving vascular risk factor control.
- Targeted interventions to improve adherence are necessary for effective secondary stroke prevention.
Objectives:
This study aimed to investigate the management of vascular risk factors, with a specific focus on understanding the various factors affecting risk factor control through an in-depth analysis of clinical data and a longitudinal follow-up of patients who have experienced ischemic strokes.
Methods:
A total of 1,572 participants were included in the analysis. We assessed thresholds for blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and glycated hemoglobin (HbA1c) levels to uncover the contextual conditions and factors affecting vascular risk factor control. Moreover, the study also scrutinized medication compliance at intervals of 3, 6, and 12 months post-onset. Logistic regression was used to adjust for confounding factors.
Results:
At 3, 6, and 12 months, BP,LDL, hemoglobin control targets were achieved in 50.7, 51.8, and 50.6%; 51.5, 59.4, and 50.6%; 48.1, 44.0, and 48.4%,respectively. Notably, age was associated with the achievement of BP control (odds ratio [OR], 0.96; 95% confidence intervals [CI], 0.94-0.98; p < 0.0001). Ethnic minorities (OR, 4.23; 95% CI, 1.19-15.09; p = 0.02) and individuals with coronary heart disease (OR, 0.5; 95% CI, 0.3-1.0; p = 0.05) experienced decreased BP control ratios. A previous history of stroke (OR, 1.7; 95% CI, 1.0-2.8; p = 0.03) and unrestricted alcohol consumption (OR, 3.3; 95% CI, 1.0-11.1; p = 0.05) was significantly associated with the achievement of lipid control. Furthermore, lifestyle modifications were significantly correlated with the achievement of BP control (OR, 0.19; 95% CI, 0.12-0.30; p < 0.01), blood glucose control (OR, 0.03; 95% CI, 0.01-0.08; p < 0.01), and blood lipid control (OR, 0.26; 95% CI, 0.16-0.42; p < 0.01). The absence of regular physical activity was associated with lower rates of glycemic (OR, 0.14; 95% CI, 0.06-0.36; p < 0.01) and lipid controls (OR, 0.55; 95% CI, 0.33-0.90; p = 0.01). Over time, overall medication compliance declined.
Conclusion:
Within the cohort of patients under medication, the compliance rate concerning vascular risk factors remains unsatisfactory. Attention should be paid to compliance with secondary prevention medications and enhance the control of vascular risk factors, as compliance emerges as the key to effective prevention.
