title: Control of main risk factors after ischaemic stroke across Europe: data from the stroke-specific module of the EUROASPIRE III survey.
abstract: BACKGROUND
  Previous cross-sectional surveys in different European countries within the EUROASPIRE programme demonstrated a high prevalence of modifiable risk factors, unhealthy lifestyles and inadequate drug treatment in coronary heart disease patients. Comparable data for ischaemic stroke patients is lacking.
  
  
  METHODS
  A stroke-specific study module was added to the EUROASPIRE III core survey. This cross-sectional multicentre survey included consecutive patients with first-ever ischaemic stroke from four European countries. Data were obtained from medical records, patient interviews and patient examinations within 6-36 months after the stroke event. Control of modifiable risk factors after stroke was evaluated against contemporary European guidelines.
  
  
  RESULTS
  A total of 881 patients was recruited. Median age was 66 years, 37.5% were female; average time from the stroke event to interview was 550 days. At the time of the interview, 17.6% of stroke patients smoked cigarettes, 35.5% had a body mass index ≥30 kg/m(2), 62.4% showed elevated blood pressure and 75.7% exhibited elevated LDL cholesterol levels. Antiplatelet drugs or oral anticoagulants were used by 87.2%, antihypertensive medication by 84.4% and statins by 56.8% of stroke patients. Among patients using antihypertensive drugs and lipid-lowering medication at the time of the interview, 34.3% and 34.4%, respectively, achieved target blood pressure and total cholesterol values according to current European guidelines.
  
  
  CONCLUSIONS
  The EUROASPIRE III stroke-specific module shows that secondary prevention and risk factor control in patients after ischaemic stroke need to be improved in four European centres at the time of the study since about half of patients are not achieving risk factor targets defined in European guidelines.
authors.affiliation: Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany Clinical Trial Center Würzburg, University Hospital Würzburg, Germany.
authors.forename: Peter U
authors.initials: PU
authors.lastname: Heuschmann
authors.affiliation: Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Kircher
authors.affiliation: Department of Neurology, Vivantes Klinikum Neukölln, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Nowe
authors.affiliation: Department of Neurology, University of Münster, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.affiliation: Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Reiner
authors.affiliation: Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic Center for Cardiovascular Prevention, Charles University Medical School I and Thomayer Hospital, Prague, Czech Republic.
authors.forename: Renata
authors.initials: R
authors.lastname: Cifkova
authors.affiliation: Department of Neurology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Branko
authors.initials: B
authors.lastname: Malojcic
authors.affiliation: Department of Medicine II University Hospital Pilsen, Czech Republic.
authors.forename: Otto
authors.initials: O
authors.lastname: Mayer
authors.affiliation: Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic Center for Cardiovascular Prevention, Charles University Medical School I and Thomayer Hospital, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bruthans
authors.affiliation: Department of Neurology, University of Krakow, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Wloch-Kopec
authors.affiliation: INSERM U970, Paris Cardiovascular Research Centre, University Paris Descartes, Paris, France.
authors.forename: Christof
authors.initials: C
authors.lastname: Prugger
authors.affiliation: Epidemiological Cancer Registry North Rhine-Westphalia, Münster, Germany Institute of Epidemiology and Social Medicine, University of Münster, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Heidrich
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster, Germany keilu@uni-muenster.de.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keil
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005060:Europe / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000379:methods* / Q000592:standards; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation; D000074606:Smoking Prevention; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiovascular disease; EUROASPIRE; risk factors; secondary prevention; stroke