Stroke in the Lehigh Valley

Alter, Milton; Sobel, Eugene; McCoy, Robert L.; Francis, Mildred E.; Davanipour, Zoreh; Shofer, F. S.; Levitt, Lawrence P.; Meehan, Edward F.

doi:10.1212/wnl.37.3.503

Cited by 57 publications

(32 citation statements)

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“…8 In that stroke cohort, hypertension was associated with a 4.5-fold increase in the risk of stroke recurrence (P<.001). The significance levels for the age-specific relative risks were 5.01 except for the risk among those aged <65 years (P=.05).…”

Section: Discussionmentioning

confidence: 77%

Hypertension and risk of stroke recurrence.

Alter

Friday

Lai

et al. 1994

Stroke

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Background and Purpose Hypertension is a risk factor for initial stroke, but its relation to stroke recurrence is unclear.Therefore, we sought to analyze the effect of hypertension and its control on risk of stroke recurrence.Methods Within 1 month of onset, a population-based cohort of 662 patients from the Lehigh Valley with an initial stroke were enrolled. Hypertension was determined at enrollment by history. Blood pressure was also measured at enrollment and at each follow-up at 4-to 6-month intervals for up to 48 months (mean, 24 months). Stroke recurrence was verified by history, examination, and review of medical reports. Various criteria for control of blood pressure were defined. History of hypertension, measured blood pressure, and its control were analyzed in relation to stroke recurrence frequency using Kaplan-Meier and univariate, multivariate, and time-dependent Cox proportional hazards models.Results At enrollment, 59.4% of the cohort had a history of hypertension and 81 patients had a second stroke. Those with

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Section: Discussionmentioning

confidence: 77%

Hypertension and risk of stroke recurrence.

Alter

Friday

Lai

et al. 1994

Stroke

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“…17 Only the MMSE was administered as a measure of cognitive function in the early period after the index ischemic stroke as part of the present study. We chose to include patients with a history of prior stroke or TIA in our analyses because previous studies have identified both prior stroke and TIA as predictors of recurrence 14,29 and we wished to examine their role in our sample.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Early Recurrence After Ischemic Stroke

Moroney

Bagiella

Paik

et al. 1998

Stroke

149

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Background and Purpose-Information regarding risk factors for early recurrence is limited. Our aim was to identify the clinical predictors of early recurrence after ischemic stroke. Methods-We prospectively examined 297 patients (mean age, 72.0Ϯ8.4 years) hospitalized with ischemic stroke to identify recurrent strokes occurring within 90 days of the index stroke. Survival free of recurrence was estimated using Kaplan-Meier analysis stratified by demographic variables; vascular risk factors; stroke syndrome, subtype, vascular territory, and severity; scores on the Barthel Index and Mini-Mental State Examination during hospitalization; blood pressure on admission; and selected laboratory data. We estimated the relative risk (RR) of early recurrence associated with those variables using proportional hazards analysis. Results-We identified 22 recurrent events in the first 90 days after the index stroke, resulting in an early stroke recurrence rate of 7.4%, and death occurred immediately after recurrence in 6 of the 22 patients. A major hemispheric stroke syndrome (RRϭ2.9; 95% confidence interval [CI]ϭ1.2 to 7.1), atherothrombotic stroke mechanism (RRϭ3.3; CIϭ1.3 to 8.3), and atrial fibrillation (RRϭ2.2; CIϭ0.8 to 6.1) were independent predictors of early recurrence, after adjustment for demographic variables. Conclusions-Early recurrence was frequent and resulted in increased mortality. Attention to the clinical features of the index stroke, including the presenting syndrome and the ischemic mechanism, and the recognition of atrial fibrillation may help in the selection of patients for the initiation of targeted interventions to prevent early recurrence and subsequent mortality. (Stroke. 1998;29:2118-2124.)

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“…The increased risk of recurrent stroke due to diabetes ranges from 2.1 to 5.6 times that of nondiabetic patients (154,156) and is independent of glucose control during the interstroke period (163). The significance of these findings is underscored by the increased morbidity and mortality associated with recurrent stroke (164).…”

Section: Hypercoaguability Conferred By Diabetes -mentioning

confidence: 99%