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Second Stroke Prevention Efforts Found Wanting
Many patients not getting services they need to prevent another attack, researchers say

By Steven Reinberg
HealthDay Reporter

THURSDAY, March 5 (HealthDay News) -- After suffering a stroke, the chances of having another are high, but a new report shows many patients aren't getting the interventions they need to reduce that risk.

Those interventions include lifestyle changes, such as smoking cessation and exercise, and medical treatments, such as aspirin, blood pressure medications and cholesterol-lowering drugs.

"The overall use of many services was suboptimal, predominantly in the 60 to 80 percent range, where ideal would be that 100 percent received each item of care we examined," said lead researcher Dr. Joseph S. Ross, a professor of geriatrics and adult development at Mount Sinai School of Medicine in New York City. "However, when we examined whether there were age, sex or racial disparities in care, we found none."

"We need to do a better job of ensuring that adults who have had a stroke receive all appropriate and recommended care in the ambulatory setting in order to prevent subsequent strokes or other problems from developing," he added.

The report was published in the March 5 online edition of Stroke.

For the study, Ross' group collected data on 11,862 men and women who had had a stroke. The researchers evaluated the use of 11 stroke prevention services taking aspirin, exercising, cholesterol reduction, managing high blood pressure, managing diabetes and preventing infectious diseases.

The researchers found that only 31 percent of the patients had rehab services. In addition, 57 percent exercised regularly, 77 percent took aspirin regularly, 66 percent had counseling to quit smoking, 62 percent of those with high blood pressure received dietary counseling, 91 percent of those with high blood pressure were taking antihypertensive medications, 89 percent of those with diabetes reported annual testing for average blood sugar, 52 percent had flu vaccinations and 53 percent received pneumococcal vaccinations.

When Ross' team looked at racial, age or gender disparities in secondary stroke prevention they didn't find any. Some 90 percent of the patients had health insurance and a regular health-care provider.

Moreover, there was no significant difference in care among patients living in the so-called Stroke Belt (Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, or Virginia.).

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