Stroke survivors face long-term risks: study

NEW YORK (Reuters Health) - The risk of a repeat stroke, which is more likely to be disabling or fatal than a first stroke, remains high long after the first stroke, a study indicates.

The study also "demonstrates the importance of different risk factors at different time points post-stroke," lead researcher Dr. Kitty M. Mohan, of King's College London, UK noted in an interview with Reuters Health.

For example, she said, high blood pressure gains importance as a risk factor for stroke recurrence in the middle and long term periods but is not significant in the early period (up to 1 year) after the initial stroke.

Mohan and her colleagues used data from the South London Stroke Register to estimate risks and predictors of long-term recurrence in 2874 patients who suffered a first stroke between 1995 and 2004 who were followed for up to 10 years.

During follow-up, 303 recurrent strokes were documented. The cumulative risk of stroke recurrence was 7.1 percent at 1 year, 16.2 percent at 5 years, and 24.5 percent at 10 years.

Patients who had a history of heart attack or the heart rhythm disorder atrial fibrillation were at increased risk for suffering another stroke in the first year after the initial stroke, the researchers found.

Pre-stroke high blood pressure and atrial fibrillation increased the risk of stroke recurrence at 5 years, while older age at first stroke, pre-stroke high blood pressure, heart attack and atrial fibrillation increased the risk of a second stroke at 10 years.

"By demonstrating different predictors for stroke recurrence in the early, medium and long term period, we have highlighted the long-term commitment needed to modify cardiovascular risk factors prior to stroke and after stroke," Mohan said.

"Knowing when a patient is likely to have their stroke recurrence means that management of their modifiable risk factors may be individually tailored in order to have an effect at the most beneficial time, therefore reducing the risk of further strokes occurring," added Mohan.

SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry, September 2009.