Survey And Follow-up Study Of Primary Prevention Of Ischemic Stroke In Risk Populations

Objective：Stroke has been the top cause of death in China. There are2.5billionnew cases of stroke every year, and1.5billion died of it in China. The situation hasbeen very serious. The purpose of this study is to investigate the condition of primaryprevention of ischemic stroke of risk populations, focusing on the condition ofawareness, treatment, control about common risk factors such as hypertension, diabetes,dyslipidemia. In addition, the aim of this study is to investigate the treatmentcompliance and analysis of related factors.Method: Cluster sampling from the1650cases came to the outpatient departmentof neurology in the first affiliated hospital of Dalian medical university from March2012to June2013, who were willing to take part in the chronic diseases screening.qualified doctors recorded627cases as samples according to their gender, age, resident,education, monthly family income, insurance type, personal history, past medicalhistory，family history of early onset of ischemic cardiovascular disease. At the sametime, their pulse，blood pressure，height, weight, fasting blood-glucose, total cholesterol,triglyceride， high-density lipoprotein， low density lipoprotein and theiracknowledgement and treatment of hypertension, diabetes, dyslipidemia were alsorecorded together with the prescription and doctor’s advice. Following up all the casesat the third month and the sixth month face to face or by telephone call, investigate theirtreatment compliance, record the reasons of non-compliance and analyze the factorsthat may influent the compliance. All the data is analyzed by SPSS18.0.Results:1) The investigation refers to627cases, aged59.7±8.8years-old, whichcontains210male (33.5%) and417female (66.5%). The factors that are related tostroke: hypertension（60.8%）,dyslipidemia（54.0%）,diabetes（27.8%）,smoker（19.9%）,fa（t14.0%）, coronary heart disease（11.5%）. The risk stratification of strokeis: low-risk group (76.1%), moderate-risk group (22.3%), high-risk group (1.6%).2) For the risk populations: The rate of awareness of hypertension is66.9%, the rate oftreatment of which is53.5%, the rate of treatment control of which is33.3%,the rate oftotal crowd control of which is17.8%, the rate of outpatient prescription ofhypertension was82.7%;the rate of awareness of diabetes is44.3%, the rate of treatmentof diabetes was29.9%, the rate of treatment control of diabetes was42.3%,the rate oftotal crowd control of diabetes was12.6%, the rate of outpatient prescription ofdiabetes was46.0%; the rate of awareness of dyslipidemia was59.0%, the rate oftreatment of dyslipidemia was26.3%, the rate of treatment control of dyslipidemia was55.0%, the rate of total crowd control of dyslipidemia was14.5%, the rate ofoutpatient prescription of dyslipidemia was38.3%. The rates of awareness, treatment,control,total crowd control and outpatient prescription of hypertension of riskpopulations are the highest, P <0.05.3) The rate of compliance of hypertension is75.0%,which of dyslipidemia is78.7%, which of diabetes is34.1%in risk populations at thethird month; The rate of compliance of hypertension is75.0%, which of dyslipidemia is78.7%, which of diabetes is34.1%in risk populations at the third month; The rate ofcompliance of hypertension is74.4%, which of dyslipidemia is76.1%, which ofdiabetes is25.2%in risk populations at the third month at the sixth month. Multiplelogistic regression analyses shows that compliance of hypertension is related toeducation, insurance type and risk stratification; that compliance of dyslipidemia isrelated to gender, age, education, insurance type and risk stratification.There is nopositive result for which related with compliance in the treatment of diabetes.Conclusion:1) In the risk populations of ischemic stroke, the rates of awareness ofhypertension, diabetes, dyslipidemia were66.9%,44.3%,59.0%, the treatment rates ofwhich were53.5%,29.9%,26.3%;the crowd control rates were17.8%,12.6%,14.5%.The index of diabetes and dyslipidemia are still at a low level.2) The treatmentcompliance rates in risk populations for hypertension, diabetes, dyslipidemia at3-monthfollow-up were:75.0%,78.7%,34.1%; the rates at6-month follow-up were:74.4%,76.1%,25.2%.The compliance rate of dyslipidemia is at the lowest level.3) For therisk populations, their treatment compliance of hypertension is related on theireducation levels, insurance types and risk stratifications; the treatment compliance of dyslipidemia is related to genders, ages, level of educations, insurance types and riskstratifications.