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Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population

The high-risk stroke populations are significantly associated with an increased risk of stroke or other vascular events. Although proven primary and secondary stroke prevention medications are available, persistent use is required to be effective. However, the persistence of drug therapy and its ass...

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Autores principales: Yi, Xingyang, Chen, Hong, Yu, Ming, Luo, Hua, Zhou, Ju, Wei, Wei, Wang, Yanfen, Chen, Xiaorong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358006/
https://www.ncbi.nlm.nih.gov/pubmed/35959409
http://dx.doi.org/10.3389/fneur.2022.925061
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author Yi, Xingyang
Chen, Hong
Yu, Ming
Luo, Hua
Zhou, Ju
Wei, Wei
Wang, Yanfen
Chen, Xiaorong
author_facet Yi, Xingyang
Chen, Hong
Yu, Ming
Luo, Hua
Zhou, Ju
Wei, Wei
Wang, Yanfen
Chen, Xiaorong
author_sort Yi, Xingyang
collection PubMed
description The high-risk stroke populations are significantly associated with an increased risk of stroke or other vascular events. Although proven primary and secondary stroke prevention medications are available, persistent use is required to be effective. However, the persistence of drug therapy and its association with outcomes in the high-risk stroke population have received limited study in China. Hence, according to the China National Stroke Screening Survey (CNSSS) program in 2015, we performed this multicenter population-based cross-sectional survey and prospective cohort study in Sichuan of southwestern China. The residents aged ≥ 40 years volunteered to participate in a face-to-face survey in 8 communities. Subjects with at least three of eight stroke-related risk factors or a history of stroke were defined as high-risk stroke population. The interviewers recorded individuals' medications at a face-to-face survey, and all the high-risk stroke population was followed up for 4.7 years. The persistence of antihypertensives, hypoglycemics, lipid-lowering medications, and antithrombotics for stroke was evaluated. The primary outcome was new stroke. Secondary outcomes included new composite vascular events of stroke, myocardial infarction, and death during follow-up periods. Among 16,892 participants, 2,893 (17.1%) participants were high-risk stroke population and 2,698 (93.3%) participants completed to follow-up. The 4.7-year persistence of therapy rate of antihypertensives, hypoglycemics, lipid-lowering medications, and antithrombotics was 38.0%, 39.9%, 43.9%, and 59.8%, respectively. The total persistence of therapy rate for antihypertensives, hypoglycemics, lipid-lowering medications, and antithrombotics was 47.6% (136/286) in patients with hypertension, diabetes, dyslipidemia, and stroke at the same time. During the 4.7-year follow-up, there were 118 (4.4%) new ischemic stroke, 24 (0.9%) hemorrhagic stroke, 53 (2.0%) myocardial infarctions, and 33 (1.2%) deaths. After adjusting for the covariates, 4.7-year persistence of antihypertensives, hypoglycemics, lipid-lowering therapy, antithrombotics, and total persistence was independently associated with less new ischemic stroke and less new composite vascular events. Thus, more effective public education and efforts to understand and enhance the persistence of drug therapy are crucial to improve population health and decrease stroke and other vascular events for the high-risk stroke population.
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spelling pubmed-93580062022-08-10 Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population Yi, Xingyang Chen, Hong Yu, Ming Luo, Hua Zhou, Ju Wei, Wei Wang, Yanfen Chen, Xiaorong Front Neurol Neurology The high-risk stroke populations are significantly associated with an increased risk of stroke or other vascular events. Although proven primary and secondary stroke prevention medications are available, persistent use is required to be effective. However, the persistence of drug therapy and its association with outcomes in the high-risk stroke population have received limited study in China. Hence, according to the China National Stroke Screening Survey (CNSSS) program in 2015, we performed this multicenter population-based cross-sectional survey and prospective cohort study in Sichuan of southwestern China. The residents aged ≥ 40 years volunteered to participate in a face-to-face survey in 8 communities. Subjects with at least three of eight stroke-related risk factors or a history of stroke were defined as high-risk stroke population. The interviewers recorded individuals' medications at a face-to-face survey, and all the high-risk stroke population was followed up for 4.7 years. The persistence of antihypertensives, hypoglycemics, lipid-lowering medications, and antithrombotics for stroke was evaluated. The primary outcome was new stroke. Secondary outcomes included new composite vascular events of stroke, myocardial infarction, and death during follow-up periods. Among 16,892 participants, 2,893 (17.1%) participants were high-risk stroke population and 2,698 (93.3%) participants completed to follow-up. The 4.7-year persistence of therapy rate of antihypertensives, hypoglycemics, lipid-lowering medications, and antithrombotics was 38.0%, 39.9%, 43.9%, and 59.8%, respectively. The total persistence of therapy rate for antihypertensives, hypoglycemics, lipid-lowering medications, and antithrombotics was 47.6% (136/286) in patients with hypertension, diabetes, dyslipidemia, and stroke at the same time. During the 4.7-year follow-up, there were 118 (4.4%) new ischemic stroke, 24 (0.9%) hemorrhagic stroke, 53 (2.0%) myocardial infarctions, and 33 (1.2%) deaths. After adjusting for the covariates, 4.7-year persistence of antihypertensives, hypoglycemics, lipid-lowering therapy, antithrombotics, and total persistence was independently associated with less new ischemic stroke and less new composite vascular events. Thus, more effective public education and efforts to understand and enhance the persistence of drug therapy are crucial to improve population health and decrease stroke and other vascular events for the high-risk stroke population. Frontiers Media S.A. 2022-07-25 /pmc/articles/PMC9358006/ /pubmed/35959409 http://dx.doi.org/10.3389/fneur.2022.925061 Text en Copyright © 2022 Yi, Chen, Yu, Luo, Zhou, Wei, Wang and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Yi, Xingyang
Chen, Hong
Yu, Ming
Luo, Hua
Zhou, Ju
Wei, Wei
Wang, Yanfen
Chen, Xiaorong
Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
title Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
title_full Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
title_fullStr Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
title_full_unstemmed Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
title_short Persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
title_sort persistence of drug therapy is associated with ischemic stroke and other vascular events in high-risk stroke population
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358006/
https://www.ncbi.nlm.nih.gov/pubmed/35959409
http://dx.doi.org/10.3389/fneur.2022.925061
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