title: Ischemic stroke risk factors during Greek economic crisis.
abstract: BACKGROUND
  The impact of Greece's economic crisis on healthcare is of great concern. The aim of the present study was to assess the impact of economic crisis on the prevention of cerebral ischemic events.
  
  
  METHODS
  Retrospective analysis of patients with ischemic stroke (IS) or transient ischemic attack (TIA) admitted to a tertiary neurological department in northwestern Greece during the period 2008-2014. Using 2011 as the transitional year IS/TIA patients were dichotomized according to their admission date in two subgroups: the "before economic crisis" subgroup and the "after economic crisis" subgroup. Logistic regression analyses were performed to identify predictor variables of statin/antihypertensive pretreatment.
  
  
  RESULTS
  Patients admitted after the economic crisis outbreak (mean age: 57.6 ± 13.5 years) were found to have lower waist periphery measurements (p = 0.001), lower incidence of diabetes (p = 0.028), hyperlipidemia (p = 0.002) and metabolic syndrome(p < 0.001), at stroke onset with lower rates of antilipidemic treatment prescription prior to stroke onset compared to those patients with cerebral ischemia that were hospitalized before the financial crisis (mean age: 59.6 ± 11.1 years). However, between the two subgroups were no significant differences in the rates of untreated patients with hyperlipidemia (p = 0.189) and/or hypertension (p = 0.313). Even though statin pretreatment prior to stroke onset was found to be reduced during economic crisis compared to the period before the crisis, (OR = 0.58, 95%CI: 0.34-0.95, p = 0.032), this association did not retain statistical significance in the multivariate logistic regression analysis (OR = 1.69, 95%CI = 0.83-3.42, p = 0.143).
  
  
  CONCLUSIONS
  Our study supports that at present financial crisis has not significantly affected the prevention of cerebrovascular events in the citizens of a provincial city area. Data from other regions and time-periods are needed for the final verdict.
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Aristeidis H
authors.initials: AH
authors.lastname: Katsanos
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Aidonio
authors.initials: A
authors.lastname: Fiolaki
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Markou
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Markoula
authors.affiliation: First Division of Internal Medicine, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kosmidou
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece; Neurosurgical Research Institute, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Athanassios P
authors.initials: AP
authors.lastname: Kyritsis
authors.affiliation: Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece; Neurosurgical Research Institute, University of Ioannina School of Medicine, Ioannina, Greece. Electronic address: sgiannop@uoi.gr.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Giannopoulos
mesh_terms: D002545:Brain Ischemia / Q000191:economics / Q000453:epidemiology*; D057172:Economic Recession; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012959:Socioeconomic Factors; D015996:Survival Rate / Q000639:trends
keywords: Dietary habits; Economic crisis; Ischemic stroke; Metabolic syndrome; Statins; Stroke risk factors