Stroke prevention: missed opportunities?
Identification and modification of risk factors can prevent strokes. Certain previously unidentified risk factors for stroke can become apparent following admission with acute stroke. The aim of the study was to investigate the prior capture, identification and management of modifiable risk factors for stroke in patients admitted to a hospital following acute stroke. One hundred consecutive stroke patients admitted to a UK hospital were prospectively assessed for modifiable risk factors. The extent of pre-admission risk factor management was also determined. Pre-admission risk factors identified and effectively managed were hypertension in non-diabetics (28%), hypertension in diabetics (7%), previous cerebrovascular event (100%), diabetes (29%), smoking (50% counselled), atrial fibrillation (81%), hypercholesterolaemia (100%), excess alcohol (22% counselled) and obesity (52% counselled). Twenty-five new modifiable risk factors were identified following incident stroke. In conclusion, a significant number of patients admitted with acute stroke have their risk factors poorly identified and controlled in the community. Despite the trial evidence available, an evidence-practice gap exists and many stroke prevention opportunities are being missed.
Department of Medicine, University Hospital, Cardiff, UK.
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Gupta
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Thomas
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*