Secondary prevention of ischemic stroke in urban China.
OBJECTIVE
We aimed to describe the uptake of proven secondary prevention strategies for ischemic stroke in urban China.


METHODS
In a prospective, multicenter, hospital-based registry of 4782 cases of acute ischemic stroke in China during 2006, the use of secondary prevention regimens was evaluated before hospital discharge and 3 and 12 months after stroke. Logistic regression analysis was performed to determine associations between various baseline variables and in-hospital use of antihypertensive, antiplatelet, and lipid-lowering therapies, and to identify variables associated with their continuation at 12 months.


RESULTS
In-hospital initiation of antihypertensive (63%), antiplatelet (81%), and lipid-lowering (31%) therapies was influenced favorably by previous use and comorbid cardiovascular risk factors and unfavorably by stroke severity. Antihypertensive use was well-maintained during follow-up, whereas use of antiplatelet and lipid-lowering therapy decreased (66% and 17%, respectively; P<0.001) by 12 months after stroke, with discontinuation related to patient and physician factors.


CONCLUSIONS
There was a high level of uptake of secondary prevention for ischemic stroke in this nationwide sample of hospitalized patients in urban China. However, use of antiplatelet and lipid-lowering therapy declined substantially after discharge, apparently related to misperceptions of subsequent disease risk by both doctors and patients.
The George Institute for International Health, PO Box M201, Missenden Rd, Camperdown NSW 2050, Australia. jwei@george.org.au
Jade W
JW
Wei
Ji-Guang
JG
Wang
Yining
Y
Huang
Ming
M
Liu
Yangfeng
Y
Wu
Lawrence K S
LK
Wong
Yan
Y
Cheng
En
E
Xu
Qidong
Q
Yang
Hisatomi
H
Arima
Emma L
EL
Heeley
Craig S
CS
Anderson
D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology* / Q000517:prevention & control*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D055502:Secondary Prevention / Q000639:trends*; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control*; D014504:Urban Health / Q000639:trends*