Secondary Prevention Falls Short After Stroke


SAN DIEGO — Far fewer patients receive the full spectrum of recommended secondary prevention interventions after suffering a neurovascular event than do patients who have suffered a cardiac event, a national database study concluded.

Dr. Eric T. Cheng, of the University of California, Los Angeles, and his associates examined data from the 2002 Medical Expenditure Panel Survey, a government-sponsored survey that sampled 15,000 representative U.S. households.

They then compared the care received by 943 people who reported a cardiac event such as myocardial infarction or angina with the care received by 523 people who had suffered a neurovascular event such as a stroke or a transient ischemic attack.

The results of the study were presented in poster form at the annual meeting of the American Neurological Association.

Both cardiac and stroke patients reported having their blood pressure and cholesterol levels measured often (97% and 96%, respectively).

These patients also were highly likely to receive advice to quit smoking (95% and 93%, respectively).

However, cardiac patients were much more likely than were neurovascular event patients to receive antithrombotic medication (83% vs. 77%), advice to exercise more (66% vs. 52%), or instruction to limit high-fat and high-cholesterol foods in their diet (70% vs. 54%).

Dr. Cheng and his associates at UCLA and the VA Greater Los Angeles Health Care System suggested that successful programs that have been used to enhance secondary preventive care after heart attacks should be replicated in the stroke population.

The Department of Veterans Affairs supported the study.

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