[Short term changes in risk factors of cerebrovascular diseases. A failure of preventive measures?].
OBJECTIVE
Stroke is the third main cause of death in western countries. To evaluate its ever-changing characteristics and the impact of recent public campaigns on cardiovascular risk factors (CRFs) in stroke morbidity and mortality, we carried out a retrospective investigation on subjects with cerebrovascular disease in different periods.


METHODS
All clinical data of patients with acute cerebrovascular disease (TIA or stroke) admitted to a regional hospital (Padua, Italy) during two distinct years (1985 and 1992) were examined (381 in 1985 and 440 in 1992). In every case the characteristics of the episode, clinical course, concomitant CRFs and relevant biochemical and instrumental examinations were recorded.


RESULTS
Altogether Transient Ischemic Attack (TIA) represented almost half the records; remaining cases could be classified as ischemic stroke (66% vs 55%), Intracerebral Haemorrhage (17% vs 26%) and subarachnoideal haemorrhage (17% vs 19%) (1985 vs 1992, respectively). The mean hospitalization period was longer in the most recent year, particularly in haemorrhagic patients (H-P, subarachnoid + intracerebral haemorrhage); the in-hospital case fatality rate was reduced in HP while it was significantly increased in those with Cerebral Ischemia (CI-P, TIA + ischemic stroke). The prevalence of blood hypertension, atrial fibrillation and dyslipidaemias rose significantly in 1992 compared to 1985. High plasma lipids were more frequently present in CI-P than in H-P; their 7-year increase was particularly related to combined forms, rather then isolated hypercholesterolemia or hypertriglyceridemia.


CONCLUSIONS
These results do not agree with an hypothetical improvement in the prognosis of stroke in the period we considered. Besides the efforts aiming at reducing CRFs in the short term have not shown to be successful.
Bilora
F
F
Dipartimento di Emergenza, Università degli Studi-Padova.
Vigna
G B
GB
Saccaro
G
G
Pastorello
M P
MP
Polato
G
G
Maifredini
C
C
Chiesa
M
M
Barbata
A
A
Vettore
G
G
San Lorenzo
L
L
D002561:Cerebrovascular Disorders / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors