Increasing prevalence of vascular risk factors in patients with stroke: A call to action

Fadar Oliver Otite, Nicholas Liaw, Priyank Khandelwal, Amer Malik, Jose G Romano, Tatjana Rundek, Ralph L Sacco, Seemant Chaturvedi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States.

METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time.

RESULTS: Across the 2004-2014 period, 92.5% of patients with AIS had ≥1 risk factor. Overall age- and sex-adjusted prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse were 79%, 34%, 47%, 15%, and 2%, respectively, while those of carotid stenosis, CRF, and CAD were 13%, 12%, and 27%, respectively. Risk factor prevalence varied by age (hypertension: 44% in 18-39 years vs 82% in 60-79 years), race (diabetes: Hispanic 49% vs white 30%), and sex (drug abuse: men 3% vs women 1.4%). Using joinpoint regression, prevalence of hypertension increased annually by 1.4%, diabetes by 2%, dyslipidemia by 7%, smoking by 5%, and drug abuse by 7%. Prevalence of CRF, carotid stenosis, and CAD increased annually by 13%, 6%, and 1%, respectively. Proportion of patients with multiple risk factors also increased over time.

CONCLUSIONS: Despite numerous guidelines and prevention initiatives, prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse in AIS increased across the 2004-2014 period. Proportion of patients with carotid stenosis, CRF, and multiple risk factors also increased. Enhanced risk factor modification strategies and implementation of evidence-based recommendations are needed for optimal stroke prevention.

Original languageEnglish (US)
Pages (from-to)1985-1994
Number of pages10
JournalNeurology
Volume89
Issue number19
DOIs
StatePublished - Nov 7 2017

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Stroke
Carotid Stenosis
Substance-Related Disorders
Dyslipidemias
Chronic Kidney Failure
Hypertension
Smoking
Coronary Artery Disease
Renal Artery
Carotid Artery Diseases
vascular factor
Hispanic Americans
Type 2 Diabetes Mellitus
Inpatients
Cardiovascular Diseases
Guidelines

ASJC Scopus subject areas

  • Clinical Neurology

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Increasing prevalence of vascular risk factors in patients with stroke : A call to action. / Otite, Fadar Oliver; Liaw, Nicholas; Khandelwal, Priyank; Malik, Amer; Romano, Jose G; Rundek, Tatjana; Sacco, Ralph L; Chaturvedi, Seemant.

In: Neurology, Vol. 89, No. 19, 07.11.2017, p. 1985-1994.

Research output: Contribution to journalArticle

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title = "Increasing prevalence of vascular risk factors in patients with stroke: A call to action",
abstract = "OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States.METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time.RESULTS: Across the 2004-2014 period, 92.5{\%} of patients with AIS had ≥1 risk factor. Overall age- and sex-adjusted prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse were 79{\%}, 34{\%}, 47{\%}, 15{\%}, and 2{\%}, respectively, while those of carotid stenosis, CRF, and CAD were 13{\%}, 12{\%}, and 27{\%}, respectively. Risk factor prevalence varied by age (hypertension: 44{\%} in 18-39 years vs 82{\%} in 60-79 years), race (diabetes: Hispanic 49{\%} vs white 30{\%}), and sex (drug abuse: men 3{\%} vs women 1.4{\%}). Using joinpoint regression, prevalence of hypertension increased annually by 1.4{\%}, diabetes by 2{\%}, dyslipidemia by 7{\%}, smoking by 5{\%}, and drug abuse by 7{\%}. Prevalence of CRF, carotid stenosis, and CAD increased annually by 13{\%}, 6{\%}, and 1{\%}, respectively. Proportion of patients with multiple risk factors also increased over time.CONCLUSIONS: Despite numerous guidelines and prevention initiatives, prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse in AIS increased across the 2004-2014 period. Proportion of patients with carotid stenosis, CRF, and multiple risk factors also increased. Enhanced risk factor modification strategies and implementation of evidence-based recommendations are needed for optimal stroke prevention.",
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T1 - Increasing prevalence of vascular risk factors in patients with stroke

T2 - A call to action

AU - Otite, Fadar Oliver

AU - Liaw, Nicholas

AU - Khandelwal, Priyank

AU - Malik, Amer

AU - Romano, Jose G

AU - Rundek, Tatjana

AU - Sacco, Ralph L

AU - Chaturvedi, Seemant

PY - 2017/11/7

Y1 - 2017/11/7

N2 - OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States.METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time.RESULTS: Across the 2004-2014 period, 92.5% of patients with AIS had ≥1 risk factor. Overall age- and sex-adjusted prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse were 79%, 34%, 47%, 15%, and 2%, respectively, while those of carotid stenosis, CRF, and CAD were 13%, 12%, and 27%, respectively. Risk factor prevalence varied by age (hypertension: 44% in 18-39 years vs 82% in 60-79 years), race (diabetes: Hispanic 49% vs white 30%), and sex (drug abuse: men 3% vs women 1.4%). Using joinpoint regression, prevalence of hypertension increased annually by 1.4%, diabetes by 2%, dyslipidemia by 7%, smoking by 5%, and drug abuse by 7%. Prevalence of CRF, carotid stenosis, and CAD increased annually by 13%, 6%, and 1%, respectively. Proportion of patients with multiple risk factors also increased over time.CONCLUSIONS: Despite numerous guidelines and prevention initiatives, prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse in AIS increased across the 2004-2014 period. Proportion of patients with carotid stenosis, CRF, and multiple risk factors also increased. Enhanced risk factor modification strategies and implementation of evidence-based recommendations are needed for optimal stroke prevention.

AB - OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States.METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time.RESULTS: Across the 2004-2014 period, 92.5% of patients with AIS had ≥1 risk factor. Overall age- and sex-adjusted prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse were 79%, 34%, 47%, 15%, and 2%, respectively, while those of carotid stenosis, CRF, and CAD were 13%, 12%, and 27%, respectively. Risk factor prevalence varied by age (hypertension: 44% in 18-39 years vs 82% in 60-79 years), race (diabetes: Hispanic 49% vs white 30%), and sex (drug abuse: men 3% vs women 1.4%). Using joinpoint regression, prevalence of hypertension increased annually by 1.4%, diabetes by 2%, dyslipidemia by 7%, smoking by 5%, and drug abuse by 7%. Prevalence of CRF, carotid stenosis, and CAD increased annually by 13%, 6%, and 1%, respectively. Proportion of patients with multiple risk factors also increased over time.CONCLUSIONS: Despite numerous guidelines and prevention initiatives, prevalence of hypertension, diabetes, dyslipidemia, smoking, and drug abuse in AIS increased across the 2004-2014 period. Proportion of patients with carotid stenosis, CRF, and multiple risk factors also increased. Enhanced risk factor modification strategies and implementation of evidence-based recommendations are needed for optimal stroke prevention.

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VL - 89

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