scholarly journals Hypertension Risk Factor Control Effort In Post Stroke Patients

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.

scholarly journals Trends of risk profile among middle-aged adults hospitalized for acute ischemic stroke in United States 2006–2017

2020 ◽  
pp. 174749302097937
Author(s):  
Xin Tong ◽  
Quanhe Yang ◽  
Mary G George ◽  
Cathleen Gillespie ◽  
Robert K Merritt
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Risk ◽  
Stroke Patients ◽  
Stroke Risk Factors ◽  
Percent Change ◽  
Lipid Disorders ◽  
Major Stroke

Background Recent studies reported increasing trends in hospitalization of stroke patients aged 35–64 years. Aim To examine changes in risk factor profiles among patients aged 35–64 years hospitalized with acute ischemic stroke between 2006 and 2017 in the United States. Methods We used data from the National Inpatient Sample of the Healthcare Cost and Utilization Project from 2006 through 2017. Principal ICD-9-CM/ICD-10-CM codes were used to identify acute ischemic stroke hospitalizations, and secondary codes were used to identify the presence of four major stroke risk factors: hypertension, diabetes, lipid disorders, and tobacco use. We used the relative percent change to assess the changes in the prevalence of risk profile between 2006–2007 and 2016–2017 and linear regression models to obtain the p values for the overall trends across six time periods. Results Approximately 1.5 million acute ischemic stroke hospitalizations occurred during 2006–2017. The prevalence of having all four risk factors increased from 4.1% in 2006–2007 to 9.1% in 2016–2017 (relative percent change 122.0%, p < 0.001 for trend), prevalence of any three risk factors increased from 24.5% to 33.8% (relative percent change 38.0%, p < 0.001). Prevalence of only two risk factors decreased from 36.1% to 32.7% (p < 0.001), only one risk factor decreased from 25.2% to 18.1% (p < 0.001), and absence of risk factors decreased from 10.1% to 6.2% (p < 0.001). The most prevalent triad of risk factors was hypertension, diabetes, and lipid disorders (14.3% in 2006–2007 and 19.8% in 2016–2017), and the most common dyad risk factors was hypertension and lipid disorders (12.6% in 2006–2007 and 11.9% in 2016–2017). Conclusions The prevalence of hospitalized acute ischemic stroke patients aged 35–64 years with all four or any three of four major stroke risk factors increased by 122% and 38%, while those with only one risk factor or no risk factor has declined by 28% and 39%, respectively, from 2006 to 2017. Younger adults are increasingly at higher risk for stroke from preventable and treatable risk factors. This growing public health problem will require clinicians, healthcare systems, and public health efforts to implement more effective prevention strategies among this population.

scholarly journals 947. Stroke demographics and risk factor profile in HIV infected individuals in Florida

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S506-S506
Author(s):  
Folusakin Ayoade ◽  
Dushyantha Jayaweera
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clinical Research ◽  
Stroke Risk ◽  
Research Network ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Risk Factor Profile ◽  
Stroke Risk Factors ◽  
Living With Hiv

Abstract Background The risk of ischemic stroke (IS) is known to be higher in people living with HIV (PLWH) than uninfected controls. However, information about the demographics and risk factors for hemorrhagic stroke (HS) in PLWH is scant. Specifically, very little is known about the differences in the stroke risk factors between HS and IS in PLWH. The goal of this study was to determine the demographics and risk factor differences between HS and IS in PLWH. Methods We retrospectively analyzed the demographic and clinical data of PLWH in OneFlorida (1FL) Clinical Research Consortium from October 2015 to December 2018. 1FL is a large statewide clinical research network and database which contains health information of over 15 million patients, 1240 clinical practices, and 22 hospitals. We compared HS and IS based on documented ICD 9 and 10 diagnostic codes and extracted information about sociodemographic data, traditional stroke risk factors, Charlson comorbidity scores, habits, HIV factors, diagnostic modalities and medications. Statistical significance was determined using 2-sample T-test for continuous variables and adjusted Pearson chi square for categorical variables. Odds ratio (OR) and 95% confidence intervals (CI) between groups were compared. Results Overall, from 1FL sample of 13986 people living with HIV, 574 subjects had strokes during the study period. The rate of any stroke was 18.2/1000 person-years (PYRS). The rate of IS was 10.8/1000 PYRS while the rate of HS was 3.7/1000 PYRS, corresponding to 25.4% HS of all strokes in the study. Table 1 summarizes the pertinent demographic and risk factors for HS and IS in PLWH in the study. Table 1: Summary of pertinent demographic and risk factors for hemorrhagic and ischemic strokes in people living with HIV from One Florida database Conclusion In this large Floridian health database, demographics and risk factor profile differs between HS and IS in PLWH. Younger age group is associated with HS than IS. However, hypertension, hyperlipidemia and coronary artery disease are more likely to contribute to IS than HS in PLWH. Further research is needed to better understand the interplay between known and yet unidentified risk factors that may be contributing to HS and IS in PLWH. Disclosures All Authors: No reported disclosures

Abstract T P136: Potential Contributors to the Declining Impact of Stroke Risk Factors with Age: Implications for Stroke Epidemiology in the Elderly

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Stroke Risk Factors ◽  
Age Related ◽  
Increased Risk ◽  
The Impact ◽  
Age Related Changes

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.

Abstract WP236: The Urban-Rural Divide: Risk Factor Prevalence in Ischemic Stroke Patients Across Two Decades

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Dinesh V Jillella ◽  
Sara Crawford ◽  
Anne S Tang ◽  
Rocio Lopez ◽  
Ken Uchino
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Regression Models ◽  
Stroke Risk ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Risk Factor Prevalence ◽  
Urban Rural ◽  
Artery Disease

Introduction: Regional disparities exist in stroke incidence and stroke related mortality in the United States. We aimed to elucidate the stroke risk factor prevalence trends based on urban versus rural location. Methods: From the National Inpatient Sample database the comorbid stroke risk factors were collected among hospitalized ischemic stroke patients during 2000-2016. Crude and age-and sex-standardized prevalence estimates were calculated for each risk factor during the time periods 2000-2008 and 2009-2016. We compared risk factor prevalence over the defined time periods using regression models, and differences in risk factor trends based on patient location categorized as urban (metropolitan with population of ≥ 1 million) and rural (neither micropolitan or metropolitan) using interaction terms in the regression models. Results: Stroke risk factor prevalence significantly increased from 2000-2008 to 2009-2016. When stratified based on patient location, most risk factors increased in both urban and rural groups. In the crude model, the urban to rural trend difference across 2000-08 and 2009-16 was significant in hypertension (p<0.0001), hyperlipidemia (p=0.0008), diabetes mellitus (p<0.0001), coronary artery disease (p<0.0001), smoking (p<0.0001) and alcohol (p=0.02). With age and sex standardization, the urban to rural trend difference was significant in hypertension (p<0.0001), hyperlipidemia (p=0.0007), coronary artery disease (p=0.01) and smoking (p<0.0001). Conclusion: The prevalence of vascular risk factors among ischemic stroke patients has increased over the last two decades. There exists an urban-rural divide, with rural patients showing larger increases in prevalence of several risk factors compared to urban patients.

Abstract P602: Stroke Risk Factors Among the Young Over Time in the GCNKSS

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Tracy E Madsen ◽  
Jane C Khoury ◽  
Kathleen S Alwell ◽  
Opeolu M Adeoye ◽  
Felipe De Los Rios La Rosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Stroke Risk ◽  
Large Population ◽  
High Cholesterol ◽  
Stroke Incidence ◽  
Stroke Risk Factors ◽  
Obesity And Diabetes ◽  
Trends Over Time ◽  
Over Time

Background: Data from the Greater Cincinnati Northern Kentucky Stroke Study (GCNKSS) have demonstrated stable or increasing stroke incidence rates in young adults with differences by sex and race, suggesting the need for targeted approaches to stroke prevention in the young. We aimed to describe trends over time in prevalence of stroke risk factors among adults ages 20-54 with stroke by sex and race. Methods: Cases of incident stroke (IS, ICH, SAH) occurring in those 20-54 years old and living in a 5-county area of southern Ohio/northern Kentucky were ascertained during 5 study periods (1993-1994, 1999, 2005, 2010, 2015). All physician-adjudicated inpatient events and a sampling of outpatient events were included, excluding nursing home events. Data on risk factors (hypertension, diabetes, obesity (BMI≥30), and high cholesterol) diagnosed prior to stroke were abstracted from medical records, and prevalence of each risk factor was reported over time in race/sex groups. Trends over time were examined using the Cochran-Armitage test. Results: Over the 5 study periods, 1204 incident strokes were included; 49% were women, 33% were black, and mean age was 46 (SD 7) years. Premorbid hypertension increased over time in Black women (48% in 1993/4 to 76% in 2015, p=0.005) but not in any other race/sex group (all p>0.05). Premorbid high cholesterol increased significantly in all race/sex groups (Figure, all p<0.05) except for White men (p=0.06). There were no significant trends over time in pre-stroke diagnoses of diabetes or obesity in any of the race/sex groups (Figure). Conclusions: Among patients aged 20-54 with incident stroke in a large population-based study, the change in the prevalence of hypertension and high cholesterol differed by sex and race, while obesity and diabetes were stable over time in all race/sex groups. Future research is needed to address risk factor control at a population level and to understand the role of undiagnosed pre-stroke risk factors in the young.

Abstract NS6: Family History of Stroke: Invisibility of a Key Stroke Risk Factor among High Risk African Americans

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Dawn M Aycock ◽  
Kenya D Kirkendoll ◽  
Kisha C Coleman ◽  
Karen C Albright ◽  
Anne W Alexandrov
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Perceived Control ◽  
Stroke Risk ◽  
Perceived Threat ◽  
Stroke Risk Factor ◽  
Stroke Risk Factors ◽  
History Of ◽  
Physiologic Data

Background & Purpose: Young to middle aged African Americans (AA) are at greater risk for a first-ever stroke, severe neurologic disability, and stroke-related mortality, than Caucasians of similar age; however, it remains unclear what role a family history of stroke (FHS) plays in promoting adoption of healthier lifestyles in this cohort. The purpose of this study was to explore differences between rural Stroke Belt AA with a FHS (e.g. parent/grandparent/sibling) on modifiable stroke risk factors, knowledge, perceived threat and perceived control of stroke, and exercise behaviors to AA without a FHS. Methods: A cross-sectional study was conducted recruiting AA aged 19-54 from the Black Belt region of Alabama via a mobile health clinic. Participants’ perceptions, knowledge, exercise history/intent, physiologic data, and health history were recorded. Results: Participants (N=66) averaged 43.3+9.4 years, were 71% female, with at least 12 years of school (89%), and unemployed (62%). Common risk factors were insufficient exercise (76%), obesity (59%), hypertension (53%; blood pressure M=145+17.6/88.3+12.9), and cigarette smoking (38%). Participants with a FHS (n=33) did not differ on average number of risk factors compared to those without a FHS (FHS 2.8+1.4 vs. 2.2+1.5; t(64)= 1.73, p=.089), nor did they differ on physiologic data. However, participants with a FHS were more likely to report a history of hypertension (67%) compared to those without a FHS (33%; χ2 =4.93, p <.05). There were no significant differences between groups for knowledge of stroke risk factors, perceived threat and perceived control of stroke, or recent exercise performance, although participants with a FHS (3.4+1.2) had significantly lower future intentions to exercise compared to those without a FHS (3.9+0.8); t(64)=2.45, p<.05). Conclusions: Although FHS is a significant non-modifiable risk factor for stroke and was common in this young to middle-aged AA cohort, FHS did not drive perceived stroke risk, risk factor control, or current/future intentions to exercise. Identification of interventions designed to personalize FHS as a key stroke risk factor, while promoting lifestyle change and self-management, may play an important role in future primary stroke prevention.

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

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1563-1569 ◽  
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.

scholarly journals 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

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217981
Author(s):  
Paul Mackie ◽  
Ishanka Weerasekara ◽  
Gary Crowfoot ◽  
Heidi Janssen ◽  
Elizabeth Holliday ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Scoping Review ◽  
Stroke Risk ◽  
Recurrent Stroke ◽  
Stroke Risk Factors ◽  
Prolonged Sitting

Relationship Between Stroke’s Risk Factors with Daily Activities Using Modified Shah Barthel Index in Chronic Stroke Patient at RSCM

2018 ◽  
Vol 24 (8) ◽  
pp. 6225-6231
Author(s):  
S Rachmayanti ◽  
W Kusumaningsih
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Stroke Risk ◽  
Chronic Stroke ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Chi Square ◽  
Stroke Risk Factors ◽  
The Relationship

Hypertension and diabetes mellitus are the most common risk factors of stroke.The study aimed to determine the relationship between stroke risk factors, hypertension and diabetes mellitus, with dependency of chronic stroke patients in Department of Medical Rehabilitation RSCM. The study is conducted by using the analytical observational cross-sectional study. The samples used in this study were 44 respondents selected by quota sampling method. The relationship between variabels was analyzed by bivariate test Chi-Square and multivariate analysis: Logistic Regression. Based on Chi-Square test, relationship between MSBI scoring with hypertension and diabetes mellitus as stroke risk factors, sequentiallly p = 0,122 and p = 0,002. Furthermore, Logistic Regression test suggested that hypertension and diabetes mellitus as stroke risk factors related to MSBI scoring, respectively; hypertension p = 0,076 (OR 4,076; CI95 0,861–19,297) and diabetes mellitus p = 0,007 (OR 22,690; CI95 2,332–220,722). Discussion: Diabetes mellitus is the most prominent risk factor in severe dependecy of chronic stroke patients.

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