Email this article MAJOR RISK FACTORS FOR STROKE AND THEIR CONTROL IN PATIENTS LIVING IN A SMALL TOWN OF THE MOSCOW REGION
- Authors: Kozyaykin V.V.1, Isakova E.V.1, Eliseev Y.V.1
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Issue: No 39 (2015)
- Pages: 56-61
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/220
- DOI: https://doi.org/10.18786/2072-0505-2015-39-56-61
- ID: 220
Cite item
Full Text
Abstract
Background: Evaluation of prevalence and degree of control of leading risk factors for stroke among population of various regions of the Russian Federation enables rational planning of preventive activities.
Aim: To analyze prevalence of the leading stroke risk factors, to assess efficacy of their control and to determine their impact on outcomes.
Materials and methods: We examined and treated 129 patients with primary and repeated cerebral accidents living in a small town of the Moscow region.
Results: The most prevalent stroke risk factor was arterial hypertension (94.6%). During 6 months before the stroke, target levels of systolic blood pressure had been achieved in 36/122 patients with arterial hypertension and those of diastolic blood pressure, in 4/122 patients. During the last 2 years preceding the index stroke, 48.8% of patients had hypertensive crises. More than half of the patients (71/122) either had not been taking their antihypertensive medications, or had not taken them regularly. There was a positive correlation between duration of arterial hypertension and degree of stroke-related disability, assessed by NIHSS (r = 0.263, p = 0.003), as well as between duration of arterial hypertension and functional activity index on Rankin scale at manifestation of stroke (r = 0.268, p = 0.003). Other prevalent risk factors were smoking (51.9% of patients), alcohol use (67.44%), diabetes mellitus (23.26%). Hypercholesterolemia that was diagnosed in 102/129 of the stroke patients, did not significantly affect any parameter of stroke severity (p > 0.05). There were weak positive correlations between body mass index and difference in NIHSS scores at admission and at discharge (r = 0.204, p = 0.049), between body mass and difference in NIHSS scores at admission and at discharge (r = 0.227, p = 0.028), as well as between body mass and difference in Rankin scale scores at admission and at discharge (r = 0.247, p = 0.016). Chronic stress situation (depression) during time period preceding the stroke was found in 37.21% of patients, but this factor had no statistically significant influence on stroke severity and outcome (p > 0.05).
Conclusion: Among patients with stroke living in a small town of the Moscow region, the most significant factors affecting severity of stroke were arterial hypertension, diabetes mellitus and obesity. An insufficient control of arterial hypertension and low compliance to treatment were found.
Keywords
About the authors
V. V. Kozyaykin
Moscow Regional Research and Clinical Institute (MONIKI)
Author for correspondence.
Email: fake@neicon.ru
Postgraduate Student, Chair of Neurology, Postgraduate Training Faculty
РоссияE. V. Isakova
Moscow Regional Research and Clinical Institute (MONIKI)
Email: isakovael@mail.ru
MD, PhD, Professor; Senior Research Fellow, Department of Neurology; Chair of Neurology, Postgraduate Training Faculty
РоссияYu. V. Eliseev
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
Junior Research Fellow, Department of Neurology
РоссияReferences
- Колчу ИГ, Волченкова ТВ, Исакова ЕВ, Котов СВ. Влияние предшествующей антигипертензивной терапии на течение церебрального инсульта. Бюллетень сибирской медицины. 2010;(4):145–7. Kolchu IG, Volchenkova TV, Isakova EV, Kotov SV. Vliyanie predshestvuyushchey antigipertenzivnoy terapii na techenie tserebral'nogo insul'ta [Influence of the previous antihypertensive therapy on the course of cerebral stroke]. Bulletin of Siberian Medicine. 2010;(4):145–7 (in Russian).
- Колчу ИГ, Романова МВ, Козяйкин ВВ, Котов СВ, Исакова ЕВ. Влияние приверженности к антигипертензивной терапии на течение и исход церебрального инсульта.
- Клиническая геронтология. 2013;(5–6):22–7. Kolchu IG, Romanova MV, Kozyaykin VV, Kotov SV, Isakova EV. Vliyanie priverzhennosti k antigipertenzivnoy terapii na techenie i iskhod tserebral'nogo insul'ta [Influence of adherence to antihypertensive therapy on the course and outcome of ischemic stroke]. Klinicheskaya gerontologiya. 2013;(5–6):22–7 (in Russian).
- Котов СВ, Исакова ЕВ, Верещагина ЕВ. Приверженность к антигипертензивной терапии у лиц из группы риска инсульта. Лечение и профилактика. 2012;(2):27–30. Kotov SV, Isakova EV, Vereshchagina EV. Priverzhennost' k antigipertenzivnoy terapii u lits iz gruppy riska insul'ta [The compliance to antihypertension therapy in patients from the stroke risk group]. Disease treatment and prevention. 2012;(2):27–30 (in Russian).
- Стаховская ЛВ, Котова СВ, ред. Инсульт. Руководство для врачей. М.: МИА; 2014. 400 с. Stakhovskaya LV, Kotov SV, editors. Insul't: rukovodstvo dlya vrachey [Stroke: Manual for doctors]. Moscow: MIA; 2014. 400 p. (in Russian).
- Гудкова ВВ, Стаховская ЛВ, Шанина ТВ, Мешкова КС, Шеховцова КВ. Антитромботическая терапия во вторичной профилактике ишемического инсульта: вопросы стратегии и тактики. Журнал неврологии и психиатрии им. C.C. Корсакова. 2011;(11):87–94. Gudkova VV, Stakhovskaya LV, Shanina TV, Meshkova KS, Shekhovtsova KV. Antitromboticheskaya terapiya vo vtorichnoy profilaktike ishemicheskogo insul'ta: voprosy strategii i taktiki [The antithrombotic treatment in the secondary prevention of ischemic stroke: strategy and tactic issues]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2011;(11):87–94 (in Russian).
- Paciaroni M, Bogousslavsky J. Primary and secondary prevention of ischemic stroke. Eur
- Neurol. 2010;63(5):267–78.
- Мисникова ИВ, Древаль АВ, Ковалева ЮА, Исакова ЕВ, Козяйкин ВВ. Риск развития ост- рых нарушений мозгового кровообраще- ния у больных сахарным диабетом второго типа. Проблемы стандартизации в здраво- охранении. 2011;(11–12):35–8.
- Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA; American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Epidemiology and Prevention; Council for High Blood Pressure Research; Council on Peripheral Vascular Disease, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/ American Stroke Association. Stroke. 2011;42(2):517–84.
- Marso SP, Kennedy KF, House JA, McGuire DK. The effect of intensive glucose control on allcause and cardiovascular mortality, myocardial infarction and stroke in persons with type 2 diabetes mellitus: a systematic review and meta-analysis. Diab Vasc Dis Res. 2010;7(2): 119–30. Misnikova IV, Dreval' AV, Kovaleva YuA, Isakova EV, Kozyaykin VV. Risk razvitiya ostrykh narusheniy mozgovogo krovoobrashcheniya u bol'nykh sakharnym diabetom vtorogo tipa [Risk of acute stroke in patients with diabetes mellitus type II]. Problemy standartizatsii v zdravookhranenii. 2011;(11–12):35–8 (in Russian).
- Hackam DG, Khan NA, Hemmelgarn BR, Rabkin SW, Touyz RM, Campbell NR, Padwal R, Campbell TS, Lindsay MP, Hill MD, Quinn RR, Mahon JL, Herman RJ, Schiffrin EL, Ruzicka M, Larochelle P, Feldman RD, Lebel M, Poirier L, Arnold JM, Moe GW, Howlett JG, Trudeau L, Bacon SL, Petrella RJ, Milot A, Stone JA, Drouin D, Boulanger JM, Sharma M, Hamet P, Fodor G, Dresser GK, Carruthers SG, Pylypchuk G, Burgess ED, Burns KD, Vallee M, Prasad GV, Gilbert RE, Leiter LA, Jones C, Ogilvie RI, Woo V, McFarlane PA, Hegele RA, Tobe SW; Canadian Hypertension Education Program. The 2010 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 – therapy. Can J Cardiol. 2010;26(5):249–58.
Supplementary files
