An approach of patients with ischemic stroke to primary and secondary stroke prevention in Poland.

INTRODUCTION

The stroke mortality rate in the Polish population is significantly higher than the average stroke mortality in Western Europe. It may prove a poor "initial" health condition of the Polish population which is afflicted with many life-threatening diseases which are at the same time the major risk factors for both: first ever and recurrent stroke. The aim of our study was to evaluate what is an attitude of Polish people with first-ever or recurrent stroke to keeping under control the most important risk factors for ischemic stroke.

MATERIAL AND METHODS

1282 consecutive patients with ischemic stroke were examined and categorized as individuals with first ever (group I - 980 patients) and recurrent stroke (group II - 302 patients). The data on the patients' previous history of stroke and vascular modifiable risk factors diagnosed before the onset of stroke: arterial hypertension (AH), type 2 diabetes mellitus (DM), ischemic heart disease (IHD), atrial fibrillation (AF), cigarette smoking and alcohol consumption were determined. The treatment with antiplatelet agents or oral anticoagulants was also taken into account.

RESULTS

More than one-third ofpatients, irrespective of group admitted that they had treated AH unsystematically or not treated at all. Based on initial blood pressure, it may be suspected, that also individuals declaring systematic AH treatment, did not do it effectively. It also concerned the type 2 DM - glycemic control remained unsatisfactory within the period preceding first-ever and recurrent stroke. After first stroke, the patients haven't changed their habits considering tobacco smoking and alcohol consumption. The anticoagulants were used relatively seldom in relation to recommendations in both group of patients.

CONCLUSIONS

The main risk factors for ischemic stroke are poorly controlled by Polish patients before first ever stroke. After the first cerebrovascular event they usually don't change their habits, which lead to recurrent stroke. In Poland the educational strategies regarding repetitive public information on benefits resulting from stroke prevention and fatal stroke consequences should be centered around the general public and the groupof high-risk patients.