Cumplimiento de las medidas de prevención de factores de riesgo vascular en pacientes ingresados con ictus agudo. Análisis de un registro multicéntrico: registro EPICES (III)

Abstract

Pharmacological and dietary measurements, as well as life style, to control risk factors are efficient procedures to prevent cerebrovascular diseases, though their implementation in the clinics seems not optimal. To identify the fulfillment of preventive measurements on a sample of 6197 hospitalized stroke patients, attended by neurologists. Analysis of a secondary objective of the EPICES registry. Primary prevention was considered in patients without previous record of transitory ischemic attack, stroke, coronary diseases and/or peripheral arterial disease (n = 3977); secondary prevention was considered in patients with record of coronary and/or peripheral arterial disease, but without record of cerebrovascular disease (n = 1047); neurological secondary prevention was considered in patients with a record of transitory ischemic attack and/or stroke, independently of the presence of coronary and/or peripheral arterial disease (n = 1173). Secondary prevention and neurological secondary prevention were more efficient than primary prevention (p = 0.028 and p < 0.0001, respectively). Control was higher in centers with some type of structure to assist stroke patients (p < 0.0001). Influence of age in the taking of therapeutic decisions followed a similar pattern in all three types of prevention, with a significant reduction on anticoagulation for patients older than 80 years. The EPICES registry confirms the poor control of risk factors for cerebrovascular diseases. Globally it demonstrated that the objectives that imply the modification of lifestyle are fulfilled worse than pharmacological preventive measurements.