(Stroke. 1999;30:16-20.)
© 1999 American Heart Association, Inc.
Original Contributions |
Risk Factor Modification in Stroke Prevention
The Experience of a Stroke Clinic
From the Departments of Neurology, Boston University School of Medicine and Boston Veterans Administration Medical Center (L.N.J., V.L.B., N.C.A.) and the School of Public Health (M.R.W.), Boston University, Boston, Mass.
Correspondence to Viken L. Babikian, MD, Department of Neurology, Boston VA Medical Center, 150 S Huntington Ave, Boston, MA 02130.
Background and Purpose—We reviewed Stroke Clinic data to determine the extent of risk factor modification achieved in patients with cerebrovascular disease over 2 years.
Methods—Visits to the Stroke Clinic of a tertiary medical center
from July 1, 1994, through June 30, 1996, were reviewed. Obesity,
smoking, hypertension, hyperlipidemia, hyperglycemia,
and lifestyle changes were noted in patients with 
2 visits (n=61) and
measures (number varied) of these parameters.
Results—Fifty-six patients (92%) had primary care
physicians. In the 49 patients with 2 weight measurements, 33 (67%)
were moderately or severely overweight by weight-height correlation.
Forty-four patients (90%) remained in the same weight category. Of the
60 patients with available blood pressure data, 50 (83%) were
hypertensive. At their last visits, 43 of the 50 (86%) were receiving
medications, and 22 of the 43 treated (51%) were controlled. Serum
glucose remained elevated in 14 of 47 patients (30%) and in 11 of 16
diabetic patients (69%). Thirty-six of 47 patients (55%) had elevated
lipid measurements. None of the 21 smokers quit during the study
period. Few patients modified dietary and exercise practices. Of 61
patients, 29 (48%) sustained vascular events during the study, with 17
of these 29 patients (59%) having strokes or transient
ischemic attacks.
Conclusions—Although most patients were asked to quit smoking, received advice regarding diet and exercise, and were medicated for hypertension, elevated glucose, and cholesterol levels, their risk factor profiles showed little improvement during the 2-year period. More effective methods of controlling stroke risk factors are needed.
Key Words: lifestyle • risk factors • stroke prevention
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