Awareness, Treatment, and Control of Vascular Risk Factors among Stroke Survivors

David A. Brenner, Rich M. Zweifler, Camilo R. Gomez, Brett M. Kissela, Deborah Levine, George Howard, Bruce Coull, Virginia J. Howard

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Introduction: Stroke survivors should recognize and control vascular risk factors to prevent recurrent strokes. We therefore assessed the prevalence, treatment, and control of hypertension, diabetes, and dyslipidemia among stroke survivors versus stroke-free control subjects. Methods: We conducted cross-sectional analysis from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study cohort, which includes oversampling from the Stroke Belt and African Americans. Patients were interviewed by telephone then visited for blood pressure, glucose, and lipid measurements. There were 2830 participants reporting a past stroke or transient ischemic attack (TIA) (stroke survivors) and 24,886 participants without past stroke or TIA (control subjects). Outcome measures included the recognition, treatment, and control of hypertension, diabetes, and dyslipidemia. Results: Stroke survivors were more likely to have unrecognized hypertension (18.7% v 13.5%, P < .0003), unrecognized stage 2 hypertension (4.4% v 2.2%, P < .0006), and unrecognized diabetes (4.2% v 3.2%, P < .026) versus control subjects. Stroke survivors were more likely to be treated for hypertension (92.4% v 89.0%, P < .0001), diabetes (88.3% v 81.4%, P < .0001), and dyslipidemia (76.3% v 61.9%, P < .0001). However, despite treatment, stroke survivors were more likely to have hypertension (33.3% v 30.4%, P = .0074) and stage 2 hypertension (9.1% v 7.6%, P = .017). Predictors of unrecognized and undertreated risk factors in stroke survivors include increasing body mass index, black race, and lower education. Conclusion: Despite having a past stroke or TIA, stroke survivors had higher rates of unrecognized hypertension, unrecognized diabetes, and undertreated hypertension. Better efforts are needed to help stroke survivors recognize and control vascular risk factors to prevent recurrent stroke.

Original languageEnglish (US)
Pages (from-to)311-320
Number of pages10
JournalJournal of Stroke and Cerebrovascular Diseases
Volume19
Issue number4
DOIs
StatePublished - Jul 1 2010

Keywords

  • Stroke
  • diabetes
  • epidemiology
  • hypertension
  • secondary stroke prevention
  • vascular risk factors

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Brenner, D. A., Zweifler, R. M., Gomez, C. R., Kissela, B. M., Levine, D., Howard, G., Coull, B., & Howard, V. J. (2010). Awareness, Treatment, and Control of Vascular Risk Factors among Stroke Survivors. Journal of Stroke and Cerebrovascular Diseases, 19(4), 311-320. https://doi.org/10.1016/j.jstrokecerebrovasdis.2009.07.001