Type

Journal Article

Authors

David Williams
Anne Hickey
Emer Shelley
Frances Horgan
Eamon Dolan
Patricia Hall
Lisa Mellon
Linda Brewer

Subjects

Medicine & Nursing

Topics
low density quality assurance secondary prevention ischaemic stroke psychology year 1 blood pressure body mass index risk factors evidence based

Secondary prevention after ischaemic stroke: the ASPIRE-S study. (2015)

Abstract Survivors of ischaemic stroke (IS) are at high-risk for future vascular events. Comprehensive information on the adequacy of secondary prevention after IS is lacking despite the knowledge that appropriate secondary prevention improves long-term patient outcomes. ASPIRE-S (Action on Secondary Prevention Interventions and Rehabilitation in Stroke) aimed to prospectively assess secondary prevention in patients 6 months following IS. Consenting patients admitted with IS to three Dublin hospitals were recruited over 1 year, from October 2011. At 6 months post IS a comprehensive assessment was completed, modelled on the EUROASPIRE protocol for evaluation of the adequacy of secondary prevention in post-discharge cardiac patients. This assessment included measurements of blood pressure, body mass index and fasting lipid and glucose profiles. Secondary preventive medications and smoking status were also documented. Three hundred two patients (58 % male) participated, of whom 256 (85 %) were followed-up at 6 months. Mean age was 69 years (range 22-95). At follow-up, 68 % of patients had a BMI >25 kg/m(2) and 16.4 % were still smoking. Almost two-thirds (63.4 %) had a blood pressure >140/90 and 23 % had low-density-lipoprotein >2.5 mmol/L. 28 % of diabetic patients had HbA1c ≥ 7 %. Ninety seven percent of patients were on anti-platelet and/or anticoagulant therapy. Of those with atrial fibrillation, 82 % were anti-coagulated (mean INR of 2.4). Ninety-five percent were on lipid-lowering therapy and three-quarters were on anti-hypertensive therapy. This prospective multi-centre survey of IS patients demonstrated a high prevalence of remaining modifiable risk factors at 6 months post stroke, despite the widespread prescription of secondary preventive medications. There is scope to improve preventive measures after IS (in particular blood pressure) by incorporating evidence-based guidelines into quality assurance cycles in stroke care.
Collections Ireland -> Royal College of Surgeons in Ireland -> School of Physiotherapy
Ireland -> Royal College of Surgeons in Ireland -> School of Physiotherapy Articles
Ireland -> Royal College of Surgeons in Ireland -> Department of Geriatric and Stroke Medicine
Ireland -> Royal College of Surgeons in Ireland -> Department of Psychology
Ireland -> Royal College of Surgeons in Ireland -> Department of Epidemiology and Public Health Medicine
Ireland -> IT Blanchardstown -> PubMed
Ireland -> Royal College of Surgeons in Ireland -> Epidemiology and Public Health Medicine Articles
Ireland -> Royal College of Surgeons in Ireland -> Division of Population Health Sciences
Ireland -> Royal College of Surgeons in Ireland -> Psychology Articles
Ireland -> Royal College of Surgeons in Ireland -> Geriatric and Stroke Medicine Articles

Full list of authors on original publication

David Williams, Anne Hickey, Emer Shelley, Frances Horgan, Eamon Dolan, Patricia Hall, Lisa Mellon, Linda Brewer

Experts in our system

1
David Williams
Royal College of Surgeons in Ireland
Total Publications: 82
 
2
Anne Hickey
Royal College of Surgeons in Ireland
Total Publications: 80
 
3
Emer Shelley
Royal College of Surgeons in Ireland
Total Publications: 51
 
4
Frances Horgan
Royal College of Surgeons in Ireland
Total Publications: 46
 
5
Eamon Dolan
IT Blanchardstown
Total Publications: 42
 
6
Patricia Hall
Royal College of Surgeons in Ireland
Total Publications: 10
 
7
Lisa Mellon
Royal College of Surgeons in Ireland
Total Publications: 23
 
8
Linda Brewer
Royal College of Surgeons in Ireland
Total Publications: 13