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Second Stroke Prevention Efforts Found Wanting
Date:3/5/2009

r average blood sugar, 52 percent had flu vaccinations and 53 percent received pneumococcal vaccinations.

When Ross' team looked at racial, age or gender disparities in secondary stroke prevention they didn't find any. Some 90 percent of the patients had health insurance and a regular health-care provider.

Moreover, there was no significant difference in care among patients living in the so-called Stroke Belt (Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, or Virginia.).

Also, 13 percent were black, a group traditionally identified as at higher risk for stroke.

"Strategies are needed to improve stroke secondary prevention, such as increasing regular activity/exercise and better dietary and tobacco cessation counseling, and these strategies need to focus on all adults, as there are not segments of the population whose care is far worse than another's," Ross said.

Dr. Larry B. Goldstein, director of the Duke Stroke Center at Duke University Medical Center, said that because the study relied on patients' own reports, it may not accurately represent the actual care they received.

"It needs to be understood that patient-reported care may or may not reflect actual care," Goldstein said.

"For example, patients who smoke might not be willing to admit that they were told to quit. They may not realize or remember what tests they may have received. Medicines other than aspirin may be used for secondary stroke prevention that apparently were not included in the survey. Not all stroke patients require outpatient rehabilitation," he said.

More information

For more about stroke, visit the U.S. National Library of Medicine.



SOURCES: Joseph S. Ross, M.D., M.H.S., professor, geriatrics and adult developm
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