Portegies MLP, et al. Stroke. 2016;doi:10.1161/STROKEAHA.116.014094.

According to new research, CVD risk factors such as high BP before a first stroke confer higher risk for subsequent stroke and dementia up to 5 years later.
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 “We already know that stroke patients have an increased risk of recurrent stroke and dementia. What we didn’t know was whether this increased risk persists for a long time after stroke and whether heart disease risk factors present before the first stroke influenced the risk of recurrent strokes or dementia,” M. Arfan Ikram, MD, PhD, from Erasmus University Medical Center in Rotterdam, Netherlands, said in a press release. “Our study found these risk factors influence future stroke and dementia and the risks persist for an extended period in some patients.”

The researchers analyzed based on propensity matching 1,237 patients with first-ever stroke and 4,928 participants without stroke from the population-based Rotterdam Study. Participants were matched based on sex, age, examination round, and date of selection. The outcomes of interest were stroke and dementia.
Ikram and colleagues calculated incidence rates of stroke and dementia for both groups and determined the population-attributable risk of prestroke CV risk factors for stroke and dementia.
Up to 1 year after first stroke, those with stroke had a threefold increased risk for stroke and a twofold increased risk for dementia compared with those without stroke, Ikram and colleagues wrote.
The researchers calculated that in the group with stroke, 39% (95% CI, 18-66) of recurrent strokes and 10% (95% CI, 0-91) of cases of dementia after stroke could be attributed to CV risk factors before stroke. The rates were similar in the group without stroke.
“Long-term risks of recurrent stroke and poststroke dementia remain high and are substantially influenced by prestroke risk factors, emphasizing the need for optimizing primary prevention,” the researchers wrote. – by Dave Quaile