Risk of Stroke Recurrence, Death, High in Those With Mini Stroke

The risk of stroke, death is high in patients who experience a stroke or a mini-stroke without early complications.

"There is a real need to maintain risk reduction strategies, medical support and healthy lifestyle choices over the long-term, even years after a mild initial event," said senior author Dr. Richard Swartz, a neurologist at Sunnybrook Health Sciences Centre, Toronto, Ontario.

How to Deal with a Stroke - Signs - Symptoms - Risk Factors - Prevention
Stroke is a brain attack, which occurs when the blood supply to the brain is interrupted. It affects all age groups; according to the WHO, 15 million people are affected by stroke annually.

‘The long term risk of stroke and death was high in those who had a transient ischemic attack and did not experience any complications.’

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Many studies show an elevated risk over time, although most have included patients with complications in the early 90-day high-risk period and not survivors without complications in the period following stroke or transient ischemic attack (TIA).

A TIA is a mini-stroke which usually resolves quickly but indicates that a patient is at high-risk of a full stroke. The risk of stroke after TIA is highest in the first 90 days, but this study shows that there continues to be an increased risk even after years of stability.

"These analyses indicate that survival after both stroke and TIA is a marker of long-term risk, which merits aggressive attention to risk reduction strategies," write the authors.

Stroke – Early Warning Signs - Risk Factor - Rehab - Treatment
Stroke can cause permanent disability and it is important to recognize its early warning signs to stop its progress. Early warning signs of stroke include sudden weakness of facial muscles.

The study included 26 366 patients who had been discharged after stroke or TIA without complications in the first 90 days at regional stroke centres in Ontario between July 2003 and March 2013, and 263 660 matched controls.

Researchers found that in the patient group who did not experience complications in the post-stroke period, the risk of complications was significantly higher over the long term compared with the controls. At 1 year, 9.5% of people experienced an adverse event such as death, stroke, heart attack or admission to long-term care, 23.6% at 3 years and 35.7% at 5 years.

High Blood Pressure
High blood pressure or hypertension is defined as a blood pressure of above 140 mm Hg (systolic) and or 90mm Hg (diastolic).

"These findings highlight the need for long-term management of modifiable risks, such as high blood pressure, monitoring and treatment of irregular heart rhythms, quitting smoking and physical activity," said Dr. Swartz.

Additional options for long-term risk reduction could include tailoring existing cardiac rehabilitation programs for stroke survivors, following patients for years rather than months after their stroke or TIA, and embedding long-term management into primary care practices.

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"For survivors of stroke or TIA, the long-term risk of recurrent stroke was particularly high, indicating that stroke recurrence is the most important modifiable outcome," the authors conclude.

Dr. Michael Hill, University of Calgary, writes "stroke is under-recognized as a major public health problem and incorrectly considered to be a disease that affects only older people. In North America and Western Europe, stroke is the third or fourth leading cause of death overall, but in the developing world is the first or second, depending on the country."

Source-Eurekalert