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.
Wei
Jade W
JW
The George Institute for International Health, PO Box M201, Missenden Rd, Camperdown NSW 2050, Australia. jwei@george.org.au
Wang
Ji-Guang
JG
Huang
Yining
Y
Liu
Ming
M
Wu
Yangfeng
Y
Wong
Lawrence K S
LK
Cheng
Yan
Y
Xu
En
E
Yang
Qidong
Q
Arima
Hisatomi
H
Heeley
Emma L
EL
Anderson
Craig S
CS
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*