scholarly journals Progress-Defining Risk Factors for Stroke Prevention

2021 ◽  
pp. 1-2
Author(s):  
Craig S. Anderson
Keyword(s):  
Risk Factors ◽  
Stroke Prevention

Controlling Hypertension and Stroke Prevention – From Guideline to Clinical Practice

2011 ◽  
Vol 3 (1) ◽  
pp. 30
Author(s):  
Anding Xu ◽  
Zefeng Tan ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Stroke Prevention ◽  
Modifiable Risk Factors ◽  
Cerebrovascular Events

Hypertension is the most important of the prevalent and modifiable risk factors for stroke. Based on evidence, blood pressure (BP) lowering is recommended in guidelines for the prevention of stroke. However, there are still some uncertainties in the guidelines for controlling BP and preventing stroke in patients with previous cerebrovascular events, such as the goal BP, who to treat and which class of BP-lowering drugs to use. This article discusses these questions by reviewing guidelines and corresponding clinical trials, with the aim of reducing the gap between guidelines and clinical practice.

Abstract WP328: A Nurse-Led Initiative Improves Adherence Rates for Stroke Follow-up and Blood Pressure Management

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Darren T Larsen ◽  
Helmi L Lutsep
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Retention Rates ◽  
Matched Cohort ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Chi Square Analysis

Background and Issues Aggressive management of vascular risk factors reduces stroke rates. It is unknown whether structured nurse-led follow up increases adherence rates for stroke patients after hospital discharge. Purpose The purpose of this program is to improve secondary stroke risk factor management by instituting a nurse-led initiative called Stroke Therapy, Education, Prevention (STEP). Methods The pilot STEP program was based on protocols used for other stroke prevention trials. This nurse-led program includes inpatient initiation and outpatient maintenance of pharmacologic and lifestyle goals for stroke patients. Eligible patients have a non-disabling ischemic stroke or TIA and are without insurance restrictions and live within a distance allowing return to clinic for follow up. Prior to discharge, the STEP nurse completes patient education, and reviews outpatient goals. The STEP nurse makes phone contact with the patient 7-10 days after discharge to review medication compliance and reinforce education. At 30 days post discharge patients are seen in clinic by the STEP nurse where a resting blood pressure (BP) is measured. If the patient does not meet targets (<140 SBP or <130 SBP for DM) medications are adjusted by a stroke neurologist. We undertook a retrospective chart review of a consecutive cohort of patients matched to STEP eligibility criteria to determine whether the program improved retention rates and BP management. Chi-Square analysis was used to compare visit adherence and percentage achieving goal BPs at 30 days. Results In the STEP group 25/32(78%) patients completed the 30 day follow up compared to 14/32 (44%) patients in the historical matched cohort (p=0.0048). Target BP was achieved in 13/25(52%) STEP patients and 5/14 (36%) matched cohort patients (p=0.32) returning to clinic. Overall, target BP was achieved in 13/32 (41%) and 5/32 (16%) respectively (p=0.026). Conclusions In conclusion, follow up adherence and BP management in the group as a whole was better in the nurse-led model and is recommended for secondary stroke prevention. Long term follow up with this model may further increase in-target rates of BP control and other stroke risk factors.

Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention

2017 ◽  
Vol 37 (03) ◽  
pp. 237-258 ◽  
Author(s):  
Amytis Towfighi ◽  
Valerie Hill
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Stroke Prevention ◽  
Health Care Systems ◽  
Dose Intensity ◽  
Lifestyle Changes ◽  
Theoretical Frameworks ◽  
Middle Income ◽  
Modifiable Factors ◽  
Care Systems

AbstractThe pathophysiology of stroke is well characterized, and 9 out of 10 strokes are due to modifiable factors. However, preventive strategies thus far have been relatively ineffective in curbing the global stroke burden, which is projected to increase given the aging of the world's population and epidemiological transition in many low- to middle-income countries. In this review we will summarize our current understanding of behavioral, environmental, and metabolic stroke risk factors not covered elsewhere in this issue. Specifically, we will review the evidence for environmental and household air pollution, smoking, and alcohol use. We will subsequently provide a conceptual framework for stroke prevention strategies, categorizing them as those aimed at changing health care systems and/or provider behavior and those targeting behaviors of patients and/or their caregivers, families, and support networks. The field of stroke prevention is relatively nascent, and little is known about how to optimize health care systems so that providers prescribe evidence-based care for stroke prevention, patients have access to care to receive such services, adherence and control of risk factors are optimized, and patients are empowered to manage their own risk factors and make lifestyle changes, including eating healthy diets (high in fruits, vegetables, and whole grains and low in sodium and sugar-sweetened beverages), engaging in regular physical activity, not smoking, and limiting alcohol consumption. In the next several years, we will likely develop a better understanding of which strategies are effective for modifying vascular risk factors, and how to design and implement successful interventions. Key questions to be answered include optimal theoretical frameworks, delivery models, team composition, timing, dose, intensity, and frequency, taking into account cultural, sociodemographic, and regional differences in patient populations.

scholarly journals Review: Stroke prevention: modifying risk factors

2008 ◽  
Vol 2 (4) ◽  
pp. 287-303 ◽  
Author(s):  
José Rafael Romero ◽  
Jane Morris ◽  
Aleksandra Pikula
Keyword(s):  
Risk Factors ◽  
Stroke Prevention

Stroke prevention: Management of modifiable vascular risk factors

2003 ◽  
Vol 250 (9) ◽  
pp. 1125-1126
Author(s):  
D. Leys ◽  
D. Deplanque ◽  
M.-A. Mackowiak-Cordoliani ◽  
C. Lucas ◽  
R. Bordet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stroke Prevention ◽  
Vascular Risk Factors ◽  
Vascular Risk

Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

Advances in Atrial Fibrillation-related Stroke Prevention

2015 ◽  
Vol 9 (2) ◽  
pp. 122
Author(s):  
Pierre Amarenco ◽  
Werner Hacke ◽  
Bo Norrving ◽  
Natalia Rost ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Oral Anticoagulants ◽  
Factor Xa ◽  
Haemorrhagic Stroke ◽  
Bleeding Events ◽  
Patients At Risk

In patients with atrial fibrillation (AF) the risk of stroke is substantially increased, especially in those who are elderly (over 75 years) or have risk factors such as previous stroke, heart failure or hypertension. Stroke outcomes are also generally much worse in those with AF. Current guidelines indicate that any patient with AF and risk factors for stroke should receive anticoagulant therapy to limit their stroke risk. Despite these established recommendations, only 50 % of patients at risk receive anticoagulation with a vitamin K antagonist (VKA) and only 50 % of those are within the therapeutic range, indicating lack of adherence to the guidelines. Withholding anticoagulant therapy is mainly left to an individual physician’s choice, as shown in the ongoing GARFIELD registry of AF stroke prevention practice. Many physicians fear the risk of intracranial haemorrhage (ICH) for which outcomes remain poor. Recent clinical studies have shown that the non-VKA oral anticoagulants (NOACs) (apixaban, rivaroxaban, dabigatran and edoxaban) significantly reduce the risk of ICH and other bleeding events, while having non-inferior stroke prevention to warfarin. Use of these drugs, limiting exposure to aspirin and alcohol and controlling blood pressure have been shown to minimise ICH risk in large clinical trials and meta-analyses. Recent data from the Effective aNticoaGulation with factor xA next GEneration in Atrial Fibrillation (ENGAGE AF)-TIMI 48 study showed that the factor Xa inhibitor edoxaban was non-inferior to well-managed warfarin for reducing all stroke risk, and significantly reduced haemorrhagic stroke, major bleeding, ICH and death. These findings further support the case for using NOAC therapy for stroke prevention in patients with AF and risk factors for stroke.

Stroke Prevention: Awareness of Risk Factors for Stroke Among African American Residents in the Mississippi Delta Region

2010 ◽  
Vol 102 (2) ◽  
pp. 84-94 ◽  
Author(s):  
Anthony M. Sallar ◽  
P. Bassey Williams ◽  
Ademola M. Omishakin ◽  
Debra Patton Lloyd
Keyword(s):  
Risk Factors ◽  
African American ◽  
Stroke Prevention ◽  
Mississippi Delta ◽  
Delta Region
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