Yale School of Medicine New Haven CT USA.
Department of Neurology, Yale Center for Brain and Mind Health Yale School of Medicine New Haven CT USA.
J Am Heart Assoc. 2023 Dec 5;12(23):e030869. doi: 10.1161/JAHA.123.030869. Epub 2023 Nov 28.
Among survivors of stroke, adherence to secondary prevention care is associated with decreased risk of recurrent stroke. However, not all survivors of stroke use secondary stroke prevention treatment. We examined the association between the disability status of survivors of stroke and their treatment and control of diabetes, hyperlipidemia, and hypertension.
In a cross-sectional analysis of the 2011 to 2018 National Health and Nutrition Examination Survey, we compared diabetes, hyperlipidemia, and hypertension treatment and control rates among self-reported survivors of stroke age ≥20 years with and without disability. Disability was defined as self-reporting any of 5 physical or 4 functional domains assessed using a structured questionnaire. Logistic regression models adjusted for age, sex, race and ethnicity, and history of medical conditions were used to estimate associations between disability status and risk factor treatment and control. The mean age of survivors of stroke was 65.1 years, and 55.5% were female; 76% (95% CI, 72.7%-79.3%) self-reported at least 1 disability. Age-standardized treatment rates for diabetes, hyperlipidemia, and hypertension were 33.1% (95% CI, 26.9%-39.2%), 67.5% (95% CI, 62.6%-72.3%), and 78.4% (95% CI, 74.6%-82.2%), respectively. Age-standardized control rates for diabetes, hyperlipidemia, and hypertension were 86.8% (95% CI, 83.8%-89.8%), 20.5% (95% CI, 15.0%-25.9%), and 47.1% (95% CI, 42.6%-51.7%), respectively. In adjusted models, those with and without disabilities had similar odds of risk factor treatment and control.
In the United States, three-quarters of survivors of stroke self-reported a disability, and these patients had similar odds of diabetes, hyperlipidemia, and hypertension treatment and control compared with those without disability.
在中风幸存者中，坚持二级预防护理与降低中风复发风险相关。然而，并非所有中风幸存者都使用中风二级预防治疗。我们研究了中风幸存者的残疾状况与其糖尿病、血脂异常和高血压的治疗和控制之间的关系。
在 2011 年至 2018 年全国健康和营养调查的横断面分析中，我们比较了年龄≥20 岁且报告有中风史的伴有和不伴有残疾的患者的糖尿病、血脂异常和高血压治疗及控制率。残疾定义为使用结构化问卷评估的 5 个身体或 4 个功能域中的任何一个报告有残疾。使用调整年龄、性别、种族和民族以及既往疾病史的 logistic 回归模型来估计残疾状况与危险因素治疗和控制之间的关联。中风幸存者的平均年龄为 65.1 岁，55.5%为女性；76%（95%CI，72.7%-79.3%）报告至少有 1 项残疾。糖尿病、血脂异常和高血压的标准化治疗率分别为 33.1%（95%CI，26.9%-39.2%）、67.5%（95%CI，62.6%-72.3%）和 78.4%（95%CI，74.6%-82.2%）。糖尿病、血脂异常和高血压的标准化控制率分别为 86.8%（95%CI，83.8%-89.8%）、20.5%（95%CI，15.0%-25.9%）和 47.1%（95%CI，42.6%-51.7%）。在调整模型中，伴有和不伴有残疾的患者具有相似的危险因素治疗和控制的可能性。
在美国，四分之三的中风幸存者报告有残疾，与无残疾患者相比，这些患者的糖尿病、血脂异常和高血压治疗和控制的可能性相似。
