Control of main risk factors after ischaemic stroke across Europe: data from the stroke-specific module of the EUROASPIRE III survey

Eur J Prev Cardiol. 2015 Oct;22(10):1354-62. doi: 10.1177/2047487314546825. Epub 2014 Aug 19.

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.

Conclusion: 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.

Keywords: Cardiovascular disease; EUROASPIRE; risk factors; secondary prevention; stroke.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Ischemia / diagnosis
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / therapy*
  • Cardiovascular Agents / therapeutic use
  • Comorbidity
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Europe / epidemiology
  • Female
  • Guideline Adherence
  • Health Care Surveys
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Life Style
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Prevalence
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior
  • Secondary Prevention / methods*
  • Secondary Prevention / standards
  • Smoking / adverse effects
  • Smoking Cessation
  • Smoking Prevention
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / therapy*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Weight Loss

Substances

  • Cardiovascular Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors