title: Challenges in secondary stroke prevention: prevalence of multiple metabolic risk factors, including abnormal glycaemia, in ischaemic stroke and transient ischaemic attack.
abstract: BACKGROUND
  Secondary prevention of ischaemic stroke (IS) and transient ischaemic attack (TIA) mandates identification and treatment of multiple metabolic risk factors. The aim was to determine the prevalence of abnormal glycaemia, hypertension and dyslipidaemia in patients presenting to an Acute Stroke Unit of a tertiary referral teaching hospital with IS or TIA.
  
  
  METHODS
  We reviewed the clinical characteristics of consecutive patients presenting with symptoms of acute stroke or TIA between 1 February 2006 and 30 June 2007 to determine the prevalence of diabetes, impaired fasting glucose (IFG), post-stroke dysglycaemia (PSD), hypertension and dyslipidaemia.
  
  
  RESULTS
  Mean age +/- SD of the 224 patients (84 female) was 71 +/- 15 years. Seventy per cent (n= 157) of patients presented with IS and 30% (n= 67) with TIA. Of the cohort, 15% (n= 33) had previously diagnosed diabetes, 10% (n= 22) were diagnosed with diabetes during admission and 19% (n= 42) had IFG diagnosed during admission. A further 4% (n= 9) were classified as having PSD. Sixty-two per cent (n= 139) of patients had previously diagnosed hypertension; another 7% (n= 15) were diagnosed during admission. Eighty-eight per cent (n= 197) of patients had dyslipidaemia. Thirty per cent had all three risk factors concurrently.
  
  
  CONCLUSIONS
  Abnormal glycaemia was present in almost half the patients presenting with IS/TIA, with the majority of cases undiagnosed. One-third of patients had abnormal glycaemia, hypertension and dyslipidaemia concurrently. Patients presenting with stroke should be routinely screened for abnormal glycaemia in concert with other vascular risk factors.
authors.affiliation: University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: D P
authors.initials: DP
authors.lastname: Scott
authors.forename: J R
authors.initials: JR
authors.lastname: Greenfield
authors.forename: V
authors.initials: V
authors.lastname: Bramah
authors.forename: J
authors.initials: J
authors.lastname: Alford
authors.forename: C
authors.initials: C
authors.lastname: Bennett
authors.forename: R
authors.initials: R
authors.lastname: Markus
authors.forename: L V
authors.initials: LV
authors.lastname: Campbell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D038321:Glycemic Index / Q000502:physiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D020521:Stroke / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D001786:Blood Glucose