Poster Session IV. Epidemiology and public health

Abstract

P475 Secondary prevention of stroke in Czech patients in the EUROASPIRE III Study Stroke Specific Module J Bruthans, O Mayer, J Simon, M Galovcova, J Hrbkova, J Belohoubek, R Cifkova, H Rosolova Institute for Clinical and Experimental Medicine, Prague, Czech Republic, Charles University School of Medicine, Pilsen, Czech Republic Topic: Stroke Aims of study: To assess the prevalence of major risk factors for ischemic stroke, to determine implementation of the secondary prevention of stroke in clinical practice. Methods: A total of 507 consecutive patients aged < 80 years and hospitalized for their first ischemic stroke in the respective district hospital (Praha 4 and Plzen-mesto) were selected retrospectively. Data were obtained from patients hospital medical records and subsequent patients history including the completion of structured questionnaires. Outpatient examination including fasting blood sampling was performed at 636 months post-stroke. The survey was carried out as part of a European study using the protocol of the EUROASPIRE III study Stroke Specific Module. Results: A total of 341 men and women were examined. Of these, at the time of examination, 636 months post stroke, 14.9% were current smokers, 38.8% were obese, 81% had blood pressure levels> 130/80 mmHg, 71.1% had increased LDL-cholesterol (> 2.5 mmol/L), 32.3% had overt diabetes (fasting blood glucose > 7 mmol/L or treatment with oral hypoglycemic agents or insulin), with only 5.5% of patients with diabetes showing satisfactory diabetes control (fasting blood glucose< 6.1 mmol/L). At the time of this examination, 78.9% of patients were receiving antiplatelet drugs or anticoagulants, 52.2% statins, 85.9% antihypertensive medication (43.1% beta-blockers, 68.9% ACE inhibitors or angiotensin II receptor blockers, 39.9% diuretics, and 32.6% calcium-channel blockers). Only a small proportion of patients were compliant with nonpharmacologic measures of secondary prevention (exercise and diet in particular). While signs of depression were possibly or likely present in 33.3% of patients, 21% of patients showed likely or probable anxiety. Conclusion: Secondary preventive lifestyle measures are inadequately implemented, with only a small proportion of patients achieving goal values of risk factors despite widely used drug therapy. The role of post-stroke rehabilitation and psychotherapy is largely underestimated.