title: Blood Pressure, smoking and oral contraceptive control after cryptogenic stroke in young adults in the PFO-ASA Study.
abstract: BACKGROUND
  Management of vascular risk factors is not optimal in stroke patients. We assessed the control of hypertension, smoking and stopping of oral contraceptive in 581 consecutive young cryptogenic ischemic stroke patients followed in the PFO-ASA study and we identified factors associated with inadequate management.
  
  
  METHODS
  At each follow-up visit, blood pressure (BP), smoking and use of oral contraceptive were recorded. Data were analyzed at 6 months, 1 and 2 years. Hypertension was defined as systolic BP > or = 140 or diastolic BP > or = 90 mm Hg, recorded in at least two follow-up visits. Current smoking was defined as more than one cigarette per day reported during at least one follow-up visit.
  
  
  RESULTS
  During follow-up, 36% of patients were hypertensive and 30% were smokers. Among the 90 hypertensive patients at baseline, 60-68% remained with high BP and among the 278 patients who were current smokers at baseline, 54-58% still smoked during follow-up. Age (OR = 1.05, 95% CI 1.02-1.08), male sex (OR = 1.42, 95% CI 0.93-2.18), body mass index > or = 27 (OR = 2, 95% CI 1.27-3.17) and known hypertension (OR = 3.08, 95% CI 1.80-5.28) were significantly associated with hypertension during follow-up. Tobacco consumption at baseline (OR = 35.2, 95% CI, 19.3-64.2), alcohol consumption at baseline (OR = 2.7, 95% CI 1.4-5.2) and Rankin < or = 2 (OR = 2.6, 95% CI 1.4-4.9) were independently associated with persistent smoking. Among the 114 women who were using combined estrogen-progesterone pills at baseline, 96.5% stopped.
  
  
  CONCLUSIONS
  Major risk factors for stroke are poorly controlled after stroke, even in the context of a prospective clinical study in young adults.
authors.affiliation: Sainte-Anne Hospital, Paris, France. arquizan@chsa.broca.inserm.fr
authors.forename: Caroline
authors.initials: C
authors.lastname: Arquizan
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Touzé
authors.forename: Thierry
authors.initials: T
authors.lastname: Moulin
authors.forename: France
authors.initials: F
authors.lastname: Woimant
authors.forename: Xavier
authors.initials: X
authors.lastname: Ducrocq
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Mas
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D003276:Contraceptives, Oral / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D020521:Stroke / Q000453:epidemiology* / Q000401:mortality
chemical_list: D003276:Contraceptives, Oral