An Examination of Modifiable Risk Factors in Stroke Survivors, with a view to recurrent stroke prevention.

BACKGROUND

Stroke is a major public health problem worldwide, as more people survive their initial stroke event and subsequently live with chronic disability. While extensive research has focused upon preventing primary strokes comparatively little research has examined secondary stroke prevention.

METHODS

We analysed data collected from a survey of 576 participants from the 45 and Up Study who had a clinical diagnosis of stroke. Health status was assessed using a variety of validated instruments. Demographics and modifiable risk factors, including health behaviours and diagnosed conditions, were also measured. Logistic regression model building was used to examine the relationship between each modifiable risk factor and the independent variables of demographics and health status measures.

RESULTS

The average time since the most recent stroke for study participants was 10.4 (SD = 8.9) years, with the majority of participants (73.2%) having had only one stroke in total. Regression modelling revealed that health-related hardiness, quality of life, depression and fatigue scores were all statistically significantly associated with heart disease, anxiety, depression and physical activity. For stroke characteristics, years since the most recent stroke was associated with heart disease and the number of strokes was associated with anxiety/nervous disorder, diabetes and alcohol consumption.

CONCLUSION

Among other identified targets for secondary stroke prevention, fatigue and depressive symptoms appear to be common factors affecting several modifiable stroke risk factors. Addressing fatigue and depressive symptoms may therefore have a positive effect on secondary stroke prevention strategies in post stroke adults. All practitioners providing care for post-stroke adults can work towards improving these health factors thereby enhancing and prioritising secondary stroke prevention strategies.