Caroline Arquizan1, Emmanuel Touzé1, Thierry Moulin2, France Woimant3, Xavier Ducrocq4, Jean‐Louis Mas1
1Sainte-Anne Hospital, Paris
2CHU Besançon Besançon
3CHU Lariboisière and Saint-Antoine, Paris, and
4CHU Nancy, Nancy, France
Tóm tắt
<i>Background:</i> Management of vascular risk factors is not optimal in stroke patients. We assessed the control of hypertension, smoking and stopping of oral contraceptive in 581 consecutive young cryptogenic ischemic stroke patients followed in the PFO-ASA study and we identified factors associated with inadequate management. <i>Methods:</i> At each follow-up visit, blood pressure (BP), smoking and use of oral contraceptive were recorded. Data were analyzed at 6 months, 1 and 2 years. Hypertension was defined as systolic BP ≧140 or diastolic BP ≧90 mm Hg, recorded in at least two follow-up visits. Current smoking was defined as more than one cigarette per day reported during at least one follow-up visit. <i>Results:</i> During follow-up, 36% of patients were hypertensive and 30% were smokers. Among the 90 hypertensive patients at baseline, 60–68% remained with high BP and among the 278 patients who were current smokers at baseline, 54–58% still smoked during follow-up. Age (OR = 1.05, 95% CI 1.02–1.08), male sex (OR = 1.42, 95% CI 0.93–2.18), body mass index ≧27 (OR = 2, 95% CI 1.27–3.17) and known hypertension (OR = 3.08, 95% CI 1.80–5.28) were significantly associated with hypertension during follow-up. Tobacco consumption at baseline (OR = 35.2, 95% CI, 19.3–64.2), alcohol consumption at baseline (OR = 2.7, 95% CI 1.4–5.2) and Rankin ≤2 (OR = 2.6, 95% CI 1.4–4.9) were independently associated with persistent smoking. Among the 114 women who were using combined estrogen-progesterone pills at baseline, 96.5% stopped. <i>Conclusions:</i> Major risk factors for stroke are poorly controlled after stroke, even in the context of a prospective clinical study in young adults.
