Need For And Clinical Effectiveness Of A Neurologist Supervised, Nurse Case Managed Stroke Risk Reduction Program
Patients who have suffered a previous stroke or TIA and those with carotid artery disease are at a heightened risk for a first or recurrent stroke. In this study, we investigated the prevalence of potentially modifiable CVD risk factors in 247 consecutive patients at a private practice neurology clinic who had previously suffered a stroke or TIA and/or had documented carotid artery disease. We also evaluated the clinical effectiveness of 12 weeks (n=125) and 1 year (n=36) of participation by these patients in a neurologist supervised, nurse case managed stroke risk reduction program. At baseline, potentially modifiable CVD risk factors included physical inactivity (68% of patients), elevated systolic BP (54% of patients), elevated LDL cholesterol (46% of patients), obesity (36% of patients), elevated diastolic BP (32% of patients), and cigarette smoking (15% of patients). On completion of 12 weeks and 1 year of program participation, clinically relevant improvements were observed for select CVD risk factors in patients with abnormal baseline values (Table). These data demonstrate that potentially modifiable CVD risk factors are often suboptimally controlled in patients at high risk for stroke. Our results further document the clinical effectiveness of a neurologist supervised, nurse case managed stroke risk reduction program.