02137nas a2200277   4500000000100000008004100001100001900042700001200061700001100073700001200084700001300096700001000109700001200119700001600131700003000147700001100177700001000188700001300198700001900211245005900230250001500289300001100304490000700315520149100322020004601813       2010                            d1 aArima Hisatomi1 aWang J.1 aLiu M.1 aWong L.1 aCheng Y.1 aXu E.1 aYang Q.1 aHeeley Emma1 aChina QUEST Investigators1 aWei J.1 aWu Y.1 aHuang Y.1 aAnderson Craig00aSecondary prevention of ischemic stroke in urban China  a2010/03/13  a967-740 v413 a<p>
BACKGROUND AND PURPOSE: We aimed to describe the uptake of proven secondary prevention strategies for ischemic stroke in urban China. METHODS: In a prospective, multicenter, hospital-based registry of 4782 cases of acute ischemic stroke in China during 2006, the use of secondary prevention regimens was evaluated before hospital discharge and 3 and 12 months after stroke. Logistic regression analysis was performed to determine associations between various baseline variables and in-hospital use of antihypertensive, antiplatelet, and lipid-lowering therapies, and to identify variables associated with their continuation at 12 months. RESULTS: In-hospital initiation of antihypertensive (63%), antiplatelet (81%), and lipid-lowering (31%) therapies was influenced favorably by previous use and comorbid cardiovascular risk factors and unfavorably by stroke severity. Antihypertensive use was well-maintained during follow-up, whereas use of antiplatelet and lipid-lowering therapy decreased (66% and 17%, respectively; P&lt;0.001) by 12 months after stroke, with discontinuation related to patient and physician factors. INTERPRETATION: There was a high level of uptake of secondary prevention for ischemic stroke in this nationwide sample of hospitalized patients in urban China. However, use of antiplatelet and lipid-lowering therapy declined substantially after discharge, apparently related to misperceptions of subsequent disease risk by both doctors and patients.
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