Cor Vasa 2008, 50(12):446-454 | DOI: 10.33678/cor.2008.167

The standard of secondary prevention of stroke in Czech patients in the EUROASPIRE III Study - Stroke Specific Module

Jan Bruthans^1,*, Otto Mayer jr.², Jaroslav Šimon², Markéta Galovcová¹, Jana Hrbková², Jiří Bělohoubek¹, Monica Patraulea², Jiří Jeschke², Hana Rosolová², Renata Cífková¹

¹ Pracoviště preventivní kardiologie, Institut klinické a experimentální medicíny, Praha

² Centrum preventivní kardiologie, II. interní klinika, Fakultní nemocnice Plzeň a Lékařská fakulta Univerzity Karlovy, Plzeň, Česká republika

Aims of study: To assess the prevalence of major risk factors for ischemic stroke, to determine implementation of the secondary prevention of stroke in clinical practice.

Methods: A total of 507 consecutive patients aged < 80 years and hospitalized for their first ischemic stroke in the respective district hospital (Praha 4 and Plzeň-město) were selected retrospectively. Data were obtained from patients' hospital medical records and subsequent patients' history including the completion of structured questionnaires. Outpatient examination including fasting blood sampling was performed at 6-36 months post-stroke. The survey was carried out as part of a European study using the protocol of the EUROASPIRE III study; Stroke Specific Module.

Results: A total of 341 men and women were examined. Of these, 14.9% were current smokers, 38.8% were obese, 81% had blood pressure levels > 130/80 mm Hg, 71.1% had increased LDL-cholesterol (> 2.5 mmol/L), 32.3% had overt diabetes (fasting blood glucose > 7 mmol/L or treatment with oral hypoglycemic agents or insulin), with only 5.5% of patients with diabetes showing satisfactory diabetes control (fasting blood glucose < 6.1 mmol/L). At the time of examination, 78.9% of patients were receiving antiplatelet drugs or anticoagulants, 52.2% statins, 85.9% antihypertensive medication (43.1% beta-blockers, 68.9% ACE inhibitors or angiotensin receptor II blockers, 39.9% diuretics, and 32.6% calcium-channel blockers). Only a small proportion of patients were compliant with non-pharmacologic measures of secondary prevention (exercise and diet in particular). While signs of depression were possibly or likely present in 33.3% of patients, 21% of patients showed likely or probable anxiety.

Conclusion: Secondary preventive lifestyle measures are inadequately implemented, with only a small proportion of patients achieving goal values of risk factors despite widely used drug therapy. The role of post-stroke rehabilitation and psychotherapy is largely underestimated.

Keywords: Secondary prevention; Ischemic stroke; EUROASPIRE III Study; Stroke Specific Module

Published: December 1, 2008  Show citation