What is the effect of interrupting prolonged sitting with frequent bouts of physical activity or standing on first or recurrent stroke risk factors? A scoping review

IntroductionIncreasing physical activity reduces secondary stroke risk factors, but many stroke survivors have low levels of physical activity. Supervised exercise delivered via telehealth has the potential to overcome barriers to increased physical activity in stroke survivors. Our scoping review will examine the emerging field of supervised exercise delivered via telehealth to map the available evidence in relation to its efficacy, acceptability, safety and feasibility in chronic conditions to inform future research into its ability to increase physical activity.Methods and analysisThe methodological framework of Arksey and O’Malley will be applied to our scoping review. A systematic search of Medline, CINAHL, Scopus, Cochrane, Pedro and Embase; hand searching of pertinent studies’ reference lists; and consultation with experts in the field will identify relevant papers. Studies involving participants with a chronic condition who undertake supervised exercise delivered by a health professional via telehealth targeted at improving secondary stroke risk factors or involving lower limb weight-bearing exercise will be included. Study selection and critical appraisal of individual studies will be carried out independently by two authors with discrepancies resolved by a third author. Quantitative and qualitative data will be charted using a standardised form. Results will be tabulated and narratively summarised to highlight findings relevant to the review’s research questions and to inform recommendations for future research.Ethics and disseminationOur review will significantly contribute to the knowledge base of exercise and rehabilitation delivered via telehealth and its application in chronic conditions, including stroke. Findings will be relevant to researchers, healthcare workers and policy-makers and will be disseminated through publication and presentations. Only secondary deidentified data will be included, therefore ethics approval will not be sought. This protocol is not registered as PROSPERO currently excludes scoping reviews.

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Derivation and Application of a Tool to Estimate Benefits From Multiple Therapies That Reduce Recurrent Stroke Risk

Stroke ◽

10.1161/strokeaha.119.027160 ◽

2020 ◽

Vol 51 (5) ◽

pp. 1563-1569 ◽

Cited By ~ 1

Author(s):

Adam Richards ◽

Nicholas J. Jackson ◽

Eric M. Cheng ◽

Robert J. Bryg ◽

Arleen Brown ◽

...

Keyword(s):

Risk Factors ◽

Risk Reduction ◽

Stroke Risk ◽

Care Delivery ◽

Recurrent Stroke ◽

Individual Risk ◽

Stroke Risk Factors ◽

Multiple Stroke ◽

Individual Risk Factors ◽

Delivery Models

Background and Purpose— Lowering blood pressure and cholesterol, antiplatelet/antithrombotic use, and smoking cessation reduce risk of recurrent stroke. However, gaps in risk factor control among stroke survivors warrant development and evaluation of alternative care delivery models that aim to simultaneously improve multiple risk factors. Randomized trials of care delivery models are rarely of sufficient duration or size to be powered for low-frequency outcomes such as observed recurrent stroke. This creates a need for tools to estimate how changes across multiple stroke risk factors reduce risk of recurrent stroke. Methods— We reviewed existing evidence of the efficacy of interventions addressing blood pressure reduction, cholesterol lowering, antiplatelet/antithrombotic use, and smoking cessation and extracted relative risks for each intervention. From this, we developed a tool to estimate reductions in recurrent stroke risk, using bootstrapping and simulation methods. We also calculated a modified Global Outcome Score representing the proportion of potential benefit (relative risk reduction) achieved if all 4 individual risk factors were optimally controlled. We applied the tool to estimate stroke risk reduction among 275 participants with complete 12-month follow-up data from a recently published randomized trial of a healthcare delivery model that targeted multiple stroke risk factors. Results— The recurrent stroke risk tool was feasible to apply, yielding an estimated reduction in the relative risk of ischemic stroke of 0.36 in both the experimental and usual care trial arms. Global Outcome Score results suggest that participants in both arms likely averted, on average, 45% of recurrent stroke events that could possibly have been prevented through maximal implementation of interventions for all 4 individual risk factors. Conclusions— A stroke risk reduction tool facilitates estimation of the combined impact on vascular risk of improvements in multiple stroke risk factors and provides a summary outcome for studies testing alternative care models to prevent recurrent stroke. Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00861081.

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Knowledge of Stroke Risk Factors and Warning Signs in Patients with Recurrent Stroke or Recurrent Transient Ischaemic Attack in Thailand

Neurology Research International ◽

10.1155/2017/8215726 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Jittima Saengsuwan ◽

Pathitta Suangpho ◽

Somsak Tiamkao

Keyword(s):

Risk Factors ◽

Transient Ischaemic Attack ◽

Stroke Risk ◽

Recurrent Stroke ◽

Warning Signs ◽

High Risk Population ◽

Cross Sectional ◽

Stroke Risk Factors ◽

Ischaemic Attack ◽

Structured Interventions

Stroke is a global burden. It is not known whether patients who are most at risk of stroke (recurrent stroke or recurrent transient ischaemic attack) have enough knowledge of stroke risk factors and warning signs. The aim of this study was to assess the knowledge of stroke risk factors and warning signs in this high-risk population. We performed a cross-sectional questionnaire-based study of patients with recurrent stroke or recurrent TIA admitted to Srinagarind Hospital and Khon Kaen Hospital, Thailand. A total of 140 patients were included in the study (age 65.6±11.3 years [mean ± SD], 62 females). Using an open-ended questionnaire, nearly one-third of patients (31.4%) could not name any risk factors for stroke. The most commonly recognized risk factors were hypertension (35%), dyslipidemia (28.6%), and diabetes (22.9%). Regarding stroke warning signs, the most commonly recognized warning signs were sudden unilateral weakness (61.4%), sudden trouble with speaking (25.7%), and sudden trouble with walking, loss of balance, or dizziness (21.4%). Nineteen patients (13.6%) could not identify any warning signs. The results showed that knowledge of stroke obtained from open-ended questionnaires is still unsatisfactory. The healthcare provider should provide structured interventions to increase knowledge and awareness of stroke in these patients.

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Prevalence of Stroke Risk Factors in an Urban Community at Parakou (Northern Benin) in 2016

10.21203/rs.3.rs-809956/v1 ◽

2021 ◽

Author(s):

Yèssito Corine Nadège Houehanou ◽

Mendinatou Agbetou ◽

Oyéné Kossi ◽

Maurice Agonnoudé ◽

Hospice Hountada ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Blood Pressure ◽

High Blood Pressure ◽

Stroke Risk ◽

Demographic Data ◽

Metabolic Risk Factors ◽

Sub Saharan Africa ◽

Metabolic Risk ◽

Stroke Risk Factors

Abstract Background: Sub-Saharan Africa faces a high burden of stroke due to growing of their risk factors. We aimed to estimate the prevalence of stroke risk factors and to identify associated factors in the district of Titirou in Parakou (northern Benin), in 2016.Methods: It was a cross-sectional study. It included adults living in Titirou and having given their consent. A door-to-door survey was performed from 15 march to 15 July 2016 in each neighbourhood or village until the expected number reached. We recorded the socio-demographic data, medical histories, anthropometric and blood pressure measures using WHO steps approach. Prevalences of stroke risk factors were calculated and a logistic regression was done to identify factors associated with metabolic risk factors.Results: A total of 4671 participants was included with a mean age of 27.7±12.9 years and a sex ratio of 0.97. Prevalences of behavioural risk factors were estimated at: 17.2% of alcohol consumption, 21.5% of low fruits and vegetables consumption, 51.1% of low physical activity practice, and 3.5% of smoking. Metabolic risk factors prevalence’s amounted to: 8.7% of obesity, 7.1% of high blood pressure, 1.7% of self-reported diabetes and 2.2% of dyslipidaemia. Age (p<0.001), sex (p<0.001), marital status (p<0.001) and professional occupation (p=0.010) were associated with obesity. Age was also associated with high blood pressure (p<0.001) and diabetes (p<0.001). Dyslipidaemia varied according to smoking (p=0.033) and low physical activity practice (p=0.003). Conclusion: The study showed high prevalences of low physical activity practice and obesity. Targeted local interventions focused on these factors should be conducted for primary prevention of stroke in this community, or even beyond in Benin.

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A Systematic Literature Review of Patients With Carotid Web and Acute Ischemic Stroke

Stroke ◽

10.1161/strokeaha.118.021907 ◽

2018 ◽

Vol 49 (12) ◽

pp. 2872-2876 ◽

Cited By ~ 25

Author(s):

Andrew J. Zhang ◽

Parth Dhruv ◽

Philip Choi ◽

Caitlin Bakker ◽

Jonathan Koffel ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Literature Review ◽

Systematic Literature Review ◽

Stroke Risk ◽

Recurrent Stroke ◽

Stroke Recurrence ◽

Carotid Revascularization ◽

Stroke Risk Factors ◽

Patient Level

Background and Purpose— Carotid web (CW) is a rare form of focal fibromuscular dysplasia defined as an abnormal shelf-like projection of intimal fibrous tissue into the carotid bulb. It is theorized that CW leads to ischemic stroke secondary to blood flow stasis and subsequent embolization. The natural history and optimal management of CW are unclear. To address this knowledge gap, we performed a systematic literature review (SLR) of CW. Methods— Our librarians performed a SLR for CW and related terminology. Patient-level demographics, stroke risk factors, neuroimaging findings, stroke recurrence or stroke free-duration, and treatment modality were extracted. We used descriptive statistics to characterize our results. When specific patient-level metrics were not reported, the denominators for reporting percentage calculations were adjusted accordingly. Results— Our literature search produced 1150 articles. Thirty-seven articles including 158 patients (median age 46 years [range 16–85], 68% women, 76% symptomatic) met entry criteria and were included in our SLR. Of the symptomatic CW patients: 57% did not have stroke risk factors, 56% who received medical therapy had recurrent stroke (median 12 months, range 0–97), and 72% were ultimately treated with carotid revascularization (50% carotid stenting, 50% carotid endarterectomy). There were no periprocedural complications or recurrent strokes in carotid revascularization patients. Conclusions— CW leads to ischemic stroke in younger patients without conventional stroke risk factors. We found a high stroke recurrence rate in medically managed symptomatic CW patients, whereas carotid revascularization effectively prevented recurrent stroke. Our findings should be interpreted with caution because of risk of publication and reporting bias.

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Effects of a physical activity and healthy eating intervention to reduce stroke risk factors in older adults

Preventive Medicine ◽

10.1016/j.ypmed.2013.07.004 ◽

2013 ◽

Vol 57 (5) ◽

pp. 708-711 ◽

Cited By ~ 2

Author(s):

Amy L. Silva-Smith ◽

Julie Fleury ◽

Michael Belyea

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Older Adults ◽

Healthy Eating ◽

Stroke Risk ◽

Stroke Risk Factors

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Sex differences in the risk of recurrent ischemic stroke after ischemic stroke and transient ischemic attack

European Stroke Journal ◽

10.1177/23969873211058568 ◽

2021 ◽

pp. 239698732110585

Author(s):

Elora Basu ◽

Setareh Salehi Omran ◽

Hooman Kamel ◽

Neal S Parikh

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Ischemic Stroke ◽

Stroke Risk ◽

Recurrent Stroke ◽

Minor Stroke ◽

Stroke Recurrence ◽

Stroke Risk Factors ◽

Minor Ischemic Stroke ◽

Using Data

Background Sex differences in stroke outcomes have been noted, but whether this extends to stroke recurrence is unclear. We examined sex differences in recurrent stroke using data from the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial. Patients and methods We assessed the risk of recurrent stroke in women compared to men using data from the POINT trial. Adults >18 years old were randomized within 12 hours of onset of minor ischemic stroke or transient ischemic attack (TIA), and followed for up to 90 days for ischemic stroke, our primary outcome. We used Cox proportional hazards model adjusted for demographics and stroke risk factors to evaluate the association between sex and stroke recurrence. We used interaction term testing and prespecified subgroup analyses to determine if the association between sex and recurrent stroke differed by age (<60 versus >60 years old), locale (US versus non-US), and index event type (stroke versus TIA). Last, we evaluated whether sex modified the effect of common stroke risk factors on stroke recurrence. Results Of 4,881 POINT trial participants with minor stroke or high-risk TIA, 2,195 (45%) were women. During the 90-day follow-up period, 267 ischemic strokes occurred; 121 were in women and 146 in men. The cumulative risk of recurrent ischemic stroke was not significantly different among women (5.76%; 95% CI, 4.84%–6.85%) compared to men (5.67%; 95% CI, 4.83%–6.63%). Women were not at a different risk of recurrent ischemic stroke compared to men (hazard ratio [HR], 1.02; 95% CI, 0.80–1.30) in unadjusted models or after adjusting for covariates. However, there was a significant interaction of age with sex (P=0.04). Among patients <60 years old, there was a non-significantly lower risk of recurrent stroke in women compared to men (HR 0.66; 95% CI 0.42–1.05). Last, sex did not modify the association between common stroke risk factors and recurrent stroke risk. Discussion and Conclusion Among patients with minor stroke or TIA, the risk of recurrent ischemic stroke and the impact of common stroke risk factors did not differ between men and women.

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Differences in the role of black race and stroke risk factors for first vs recurrent stroke

Neurology ◽

10.1212/wnl.0000000000002376 ◽

2016 ◽

Vol 86 (7) ◽

pp. 637-642 ◽

Cited By ~ 20

Author(s):

George Howard ◽

Brett M. Kissela ◽

Dawn O. Kleindorfer ◽

Leslie A. McClure ◽

Elsayed Z. Soliman ◽

...

Keyword(s):

Risk Factors ◽

Stroke Risk ◽

Recurrent Stroke ◽

Black Race ◽

Stroke Risk Factors

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Implications of Female Sex on Stroke Risk Factors, Care, Outcome and Rehabilitation: An Asian Perspective

Cerebrovascular Diseases ◽

10.1159/000381832 ◽

2015 ◽

Vol 39 (5-6) ◽

pp. 302-308 ◽

Cited By ~ 15

Author(s):

Prachi Mehndiratta ◽

Mohammad Wasay ◽

Man Mohan Mehndiratta

Keyword(s):

Risk Factors ◽

Access To Health Care ◽

Stroke Risk ◽

Contraceptive Use ◽

Social Issues ◽

Recurrent Stroke ◽

Stroke Care ◽

Asian Women ◽

Chewing Tobacco ◽

Stroke Risk Factors

Background: Stroke affects 16.9 million people annually and the greatest burden of stroke is in low- and middle-income countries, where 69% of all strokes occur. Stroke risk factors, mortality and outcomes differ in developing countries as compared to the developed world. We performed a literature review of 28 articles pertaining to epidemiology of stroke in Asian women, stroke risk factors, gender-related differences, and stroke outcomes. Summary: Asian women differ from women worldwide due to differences in stroke awareness, risk factor profile, stroke subtypes, and social issues that impact stroke care. While Asian men have a higher incidence of stroke as compared to women overall, the long- and short-term outcomes in Asian women tend to be poorer. Both conventional and gender-specific risk factors contribute to stroke risk. Oral contraceptive use and addictions such as tobacco and alcohol are less prevalent among Asian women due to socio cultural differences. There is however, a much higher preponderance of pregnancy-related stroke and cardio-embolic stroke secondary to rheumatic heart disease and heavy use of chewing tobacco. The overall outcome is poor due to poor access to health care and lack of resources. Key Messages: Our review exposed the gaps in our knowledge about stroke risk factors and differences in stroke care provided to Asian women. While there are sociocultural barriers that impede the provision of immediate care to these stroke patients, much needs to be done by way of prevention of recurrent stroke and treatment of risk factors.

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Hypertension Risk Factor Control Effort In Post Stroke Patients

ABDIMAS: Jurnal Pengabdian Masyarakat ◽

10.35568/abdimas.v4i2.1109 ◽

2022 ◽

Vol 4 (2) ◽

pp. 639-644

Author(s):

Yosi Suryarinilsih ◽

Hendri Budi ◽

Netti Netti ◽

Wiwi Sartika

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Health Education ◽

Stroke Risk ◽

Recurrent Stroke ◽

Stroke Patients ◽

Post Stroke ◽

Stroke Risk Factors ◽

Breathing Exercises ◽

Significant Difference

Post-stroke patients have risk factors for recurrent stroke. The main risk factor is hypertension. The purpose of this community service activity is to improve the ability of the community, especially post-stroke patients, to control hypertension as a risk factor for recurrent stroke through identification of risk factors, health education and the application of light activity and deep breathing exercises. Before education is given, post-stroke patients and their families are given prestest first and after education, posttest returns to evaluate the patient's understanding. The results of the activity, there was a significant difference between the knowledge before and after being given education to post-stroke patients and their families with p value <0.05. To the head of the room and the neuroscientific nurse, dr. M. Djamil Padang can continue the activity of identifying recurrent stroke risk factors and health education related to control of recurrent stroke risk factors in post-stroke patients by involving the Health Promotion (Promkes) department of Dr. M. Djamil Padang.

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