Abstract
AIM: To investigate the association between medication use and long-term all-cause mortality in a Brazilian stroke cohort.
METHODS: Both ischemic and hemorrhagic stroke were evaluated. Medication use was assessed as: never, only pre-stroke, only post-stroke, and continuous use. We evaluated anti-hypertensives, anti-diabetics, lipid-lowering drugs, anti-platelets, and anti-coagulants. Cox regression models were adjusted for sociodemographic and cardiovascular risk factors.
RESULTS: Among 1173 incident stroke cases (median age: 68; 86.8% were ischemic, 70% first-ever stroke), medication use was low (overall: 17.5% pre-stroke, 26.4% post-stroke, and 40% were under continuous use). Anti-hypertensives and anti-platelets (aspirin) were the continuous cardiovascular medications used most often, at 83.5% and 72%, respectively, while statins (39.7%) and anti-diabetics (31.3%) were the least used. Medication use (pre-stroke, post-stroke and continuous use) was associated with a reduction in all-cause mortality risk, particularly among those under continuous use (multivariable hazard ratio, 0.52; 95% confidence interval (CI), 0.46-0.66) compared with never-users. Among ischemic stroke patients, this effect was similar (multivariable hazard ratio, 0.52; 95% CI, 0.40-0.68). No significant associations were evident among hemorrhagic stroke patients.
CONCLUSIONS: The risk of all-cause mortality was reduced by 48% among those with ischemic stroke under continuous use of medications. Secondary prevention should be emphasized more strongly in clinical practice. Geriatr Gerontol Int 2022; ••: ••-••.
| Original language | English |
|---|---|
| Pages (from-to) | 715-722 |
| Number of pages | 8 |
| Journal | Geriatrics & gerontology international |
| Volume | 22 |
| Issue number | 9 |
| Early online date | 3 Aug 2022 |
| DOIs | |
| Publication status | Published - Sept 2022 |
Bibliographical note
Funding Information:This study was funded by the Sao Paulo Research Support Foundation of the State of São Paulo (FAPESP) (grant no. 2018/05512–3) and by the NIHR Global Health Research Group on AF (grant no. 17/63/121).
Publisher Copyright:
© 2022 Japan Geriatrics Society.
Keywords
- mortality of stroke
- stroke epidemiology
- stroke secondary prevention and medication use
ASJC Scopus subject areas
- Health(social science)
- Geriatrics and Gerontology
- Gerontology
Access to Document
- SouzaK2022Cardiovascular
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