Clinical Research Centre, Hvidovre Hospital, Hvidovre, Denmark.
Int J Stroke. 2010 Jun;5(3):157-62. doi: 10.1111/j.1747-4949.2010.00424.x.
Recurrent stroke accounts for about 25% of admissions for acute stroke. For the prevention of recurrent cerebro and cardiovascular disease, stroke patients are advised to change modifiable stroke risk factors before discharge from stroke units.
To investigate the change in modifiable risk factors 1 year after stroke and to explore the feasibility of a preventive programme aimed at stroke patients discharged from hospital.
From April 2004 to February 2005, 173 patients admitted to hospital with a diagnosis of stroke were consecutively included and interviewed about their medical history and modifiable risk factors before stroke. One-year follow-up with measurement of blood pressure was performed in 92% of surviving and able participants.
One year after discharge, 121 participants were reinterviewed and 118 had their blood pressure measured. We found uncontrolled hypertension in 43 of 65 patients (66% of those receiving antihypertensive medication) and unknown hypertension in 30 of 53 patients (57% of those without antihypertensive medication). There was a reduction in the prevalence of excessive consumption of alcohol from 24 of 121 patients (20%) to 16 of 121 patients (13%) (P<0.05). The frequency of cigarette intake remained unchanged: 57 of 121 patients (47%) 1 year after stroke. The proportion of patients who were physically inactive increased from 36% (43 of 121 patients) before stroke to 59% (71 of 121) 1 year later (P<0.0001).
The change in modifiable risk factors was inadequate 1 year after stroke. The pilot study indicated that a preventive programme should focus on hypertension, smoking and physical inactivity.
复发性卒中占急性卒中住院患者的 25%左右。为了预防脑卒中和心血管疾病的再次发生，建议卒中患者在离开卒中单元前改变可改变的卒中风险因素。
调查卒中后 1 年可改变风险因素的变化，并探讨针对出院卒中患者的预防计划的可行性。
2004 年 4 月至 2005 年 2 月，连续纳入 173 名因卒中住院的患者，并对他们的卒中前病史和可改变的风险因素进行了采访。对 92%存活且能参与的患者进行了 1 年的随访，测量了血压。
出院后 1 年，121 名患者接受了再次采访，118 名患者测量了血压。我们发现，在接受降压药物治疗的 65 名患者中，有 43 名（66%）血压未得到控制，在未接受降压药物治疗的 53 名患者中，有 30 名（57%）患有未确诊的高血压。过量饮酒的患病率从 121 名患者中的 24 名（20%）降至 121 名患者中的 16 名（13%）（P<0.05）。吸烟的频率保持不变：121 名患者中有 57 名（47%）在卒中后 1 年仍吸烟。身体不活动的患者比例从卒中前的 36%（121 名患者中有 43 名）增加到 1 年后的 59%（121 名患者中有 71 名）（P<0.0001）。
卒中后 1 年可改变风险因素的变化不充分。该初步研究表明，预防计划应重点关注高血压、吸烟和身体不活动。
