title: Recurrence after ischemic stroke in chinese patients: impact of uncontrolled modifiable risk factors.
abstract: BACKGROUND
  Data concerning stroke occurrence and recurrence in China are extremely rare. This study was designed to analyze determinants of stroke recurrence in a cohort of Chinese patients.
  
  
  METHODS
  Subjects were patients with ischemic stroke registered in the Nanjing Stroke Registry Program. Modifiable risk factors for stroke were identified and stratified into 3 levels: without, controlled and uncontrolled. Cox proportional hazard model was used to detect influence factors for stroke recurrence.
  
  
  RESULTS
  First-year recurrence rate was 11.2% in the registered patients. Hypertension, atrial fibrillation (AF) and smoking were associated with increased risk of recurrence. Controlling hypertension and AF each halved recurrent risk (p < 0.001). Ceasing smoking for more than 1 year reduced hazard ratio of recurrence from 1.71 to 1.39 (p < 0.05). Controlling blood sugar level in diabetics did not significantly change recurrent risk (hazard ratio, 1.69 vs. 1.64, p > 0.05).
  
  
  CONCLUSIONS
  The recurrence rate is higher in Chinese patients with ischemic stroke compared with the one reported in western populations. Failure to control some modifiable risk factors in Chinese patients may be responsible for this discrepancy.
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China.
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
authors.forename: Wentao
authors.initials: W
authors.lastname: Wu
authors.forename: Renliang
authors.initials: R
authors.lastname: Zhang
authors.forename: Qin
authors.initials: Q
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044466:Asian People / Q000706:statistics & numerical data*; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D020521:Stroke / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents