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Stress of Caring for Disabled Spouse Raises Stroke Threat
Date:1/14/2010

or long enough to do that analysis," Haley said. "Over the next several years, we will have the ability to see whether high degrees of strain lead to a higher incidence of stroke and mortality."

Caregivers who feel the strain can and should seek help, he advised. "We do know already that caregivers can benefit from all sorts of counseling," Haley said. "We encourage those caregivers to get additional assistance."

Another study in the same issue of the journal, this one from Sweden, found that only half to three-quarters of people who survived strokes were still taking recommended drugs to prevent a new stroke two years later.

The study of more than 21,000 stroke survivors, average age 75, found that two years later, 26 percent had stopped taking drugs to control high blood pressure, 44 percent had stopped taking cholesterol-lowering statins, 36 percent had stopped taking clot-preventing medications and 55 percent were not taking the blood thinner warfarin.

It's not clear whether the same pattern of noncompliance is true for the United States, wrote the neurologists from Umea University Hospital, but "it is very much so here," said Dr. Bruce Ovbiagele, director of the stroke prevention program at the University of California, Los Angeles.

There are several possible explanations for failure to take such basic measures to prevent another stroke, Ovbiagele said. "On the part of the patients, many patients are not clear that they need to be on these medications indefinitely," he noted.

Physicians can also be at fault, Ovbiagele added. "Some providers are not as insistent about educating patients about how long they need to be on these medications," he said. "Most evidence of their value comes from relatively short studies, so providers may not think it is evident that they have to be continued."

Patient compliance with medication instructions after a stroke is best when "there is some structured inter
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