Risk factors among stroke patients on the rise

Physicians are aware of stroke risk factors at this point, but something is getting lost in translation.

Despite educational and prevention efforts, stroke patients are increasingly showing up at hospitals with one or more risk factors, according to a study published Oct. 11 in Nature.

Researchers studied more than 900,000 cases of ischemic stroke from 2004 and 2014. A total of 92.5 percent of patients had at least one risk factor, and most of the risk factors increased in prevalence as the study progressed.

“An estimated 80 percent of all first strokes are due to risk factors that can be changed, such as high blood pressure, and many efforts have been made to prevent, screen for and treat these risk factors,” lead author Fadar Oliver Otite, MD, ScM, of the University of Miami Miller School of Medicine, said in a press release. “Yet we saw a widespread increase in the number of stroke patients with one or more risk factors. These alarming findings support the call for further action to develop more effective methods to prevent and control these risk factors to reduce stroke risk.”

Other key findings of the study:

• The proportion of patients with at least one risk factor grew from 88 percent in 2004 to 95 percent in 2014. The proportion of patients with multiple risk factors also increased over time.
• Nearly half (49 percent) of Hispanic stroke patients had diabetes, compared to 44 percent of African-Americans and 30 percent of whites.
• From 2004 to 2014, the prevalence of high cholesterol (29 percent to 59 percent), diabetes (31 to 38 percent) and high blood pressure (73 to 84 percent) all increased.
• The amount of stroke patients who smoked or abused drugs increased annually by five and seven percent, respectively, over the course of the study.

Otite and colleagues pointed out improved screening and detection of risk factors may have played a role in the results. In addition, definitions of some risk factors may have changed over time, leading to inconsistent recording of those factors.

Still, the findings are cause for alarm, Otite said.

"While we have made great strides in reducing the proportion of people who die from stroke, we still have progress to make on preventing stroke and better controlling these risk factors,” he said.