Risk factors of the recurrence of ischemic stroke

Objective: Data on the recurrence of ischemic stroke in the Chinese population are rarely reported.This study was designed to analyze the determinants of its recurrence in a cohort of Chinese patients.Methods: The subjects were ischemic stroke patients registered in Nanjing Stroke Registry Program and followed up for 2 years.Modifiable risk factors for stroke were identified and stratified into 3 levels: no,controlled and uncontrolled.The Cox proportional hazard model was used to detect the factors of stroke recurrence.Results: The first-year recurrence rate of ischemic stroke was 11.2% in the registered patients.Hypertension,atrial fibrillation(AF) and smoking were associated with the increased risk of recurrence.The hazard ratio(HR) of recurrence was halved in the hypertension patients with their blood pressure effectively controlled and in the AF patients treated with anticoagulant drug(P 0.01) and reduced from 1.71 to 1.39 in those who ceased smoking for over a year(P 0.05),but had no significant difference between the diabetic patients who had controlled the blood sugar level and those who had not(HR:1.69 vs 1.64,P 0.05).Conclusion: The recurrence rate of ischemic stroke is a little higher in Chinese patients than in Western populations,but it can be effectively reduced by control of high blood pressure,anticoagulant medication for AF and cessation from smoking.