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Table of Contents
Vol. 25, No. 4, 2008
Issue release date: April 2008
Section title: Original Paper
Cerebrovasc Dis 2008;25:366–374
(DOI:10.1159/000120687)

Risk Factor Profile and Management of Cerebrovascular Patients in the REACH Registry

Röther J.a · Alberts M.J.b · Touzé E.h · Mas J.-L.h · Hill M.D.j · Michel P.k · Bhatt D.L.c · Aichner F.T.p · Goto S.o · Matsumoto M.l · Ohman E.M.d · Okada Y.m · Uchiyama S.n · D’Agostino R.e · Hirsch A.T.f · Wilson P.W.F.g · Steg P.G.i
aDepartment of Neurology, Klinikum Minden, Hannover Medical School, Minden, Germany; bDepartment of Neurology, Northwestern University Medical Center, Chicago, Ill., cDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, dDivision of Cardiology, Duke Medical University, Durham, N.C., eStatistics and Consulting Unit, Boston University, Boston, Mass., fMinneapolis Heart Institute Foundation and Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minn., and gCardiology Division, Emory University School of Medicine, Atlanta, Ga., USA; hService de Neurologie, Paris-Descartes University, Hôpital Saint-Anne, and iDépartement de Cardiologie, Hôpital Bichat-Claude Bernard, Paris, France; jDepartment of Clinical Neuroscience, University of Calgary, Foothills Medical Center, Calgary, Alta., Canada; kDepartment of Neurology, Lausanne University Hospital, Lausanne, Switzerland; lDepartment of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, mDepartment of Cerebrovascular Disease, Kyushu Medical Center, Fukuoka, nDepartment of Neurology, Tokyo Women’s Medical College, Tokyo, and oResearch Unit of Atherothrombosis, Tokai University School of Medicine, Isehara, Japan; pDepartment of Neurology, Hospital Wagner-Jauregg, Linz, Austria

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: September 28, 2007
Accepted: December 18, 2007
Published online: March 13, 2008
Issue release date: April 2008

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 5

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Background: Cerebrovascular disease (CVD) is a global public health problem. CVD patients are at high risk of recurrent stroke and other atherothrombotic events. Prevalence of risk factors, comorbidities, utilization of secondary prevention therapies and adherence to guidelines all influence the recurrent event rate. We assessed these factors in 18,992 CVD patients within a worldwide registry of stable outpatients. Methods: The Reduction of Atherothrombosis for Continued Health Registry recruited >68,000 outpatients (44 countries). The subjects were mainly recruited by general practitioners (44%) and internists (29%) if they had symptomatic CVD, coronary artery disease, peripheral arterial disease (PAD) and/or ≧3 atherothrombotic risk factors. Results: The 18,992 CVD patients suffered a stroke (53.7%), transient ischemic attack (TIA) (27.7%) or both (18.5%); 40% had symptomatic atherothrombotic disease in ≧1 additional vascular beds: 36% coronary artery disease; 10% PAD and 6% both. The prevalence of risk factors at baseline was higher in the TIA subgroup than in the stroke group: treated hypertension (83.5/82.0%; p = 0.02), body mass index ≧30 (26.7/20.8%; p < 0.0001), hypercholesterolemia (65.1/52.1%; p < 0.0001), atrial fibrillation (14.7/11.9%; p < 0.0001) and carotid artery disease (42.3/29.7%; p < 0.0001). CVD patients received antiplatelet agents (81.7%), oral anticoagulants (17.3%), lipid-lowering agents (61.2%) and antihypertensives (87.9%), but guideline treatment targets were frequently not achieved (54.5% had elevated blood pressure at baseline, while 4.5% had untreated diabetes). Conclusions: A high percentage of CVD patients have additional atherothrombotic disease manifestations. The risk profile puts CVD patients, especially the TIA subgroup, at high risk for future atherothrombotic events. Undertreatment is common worldwide and adherence to guidelines needs to be enforced.

© 2008 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: September 28, 2007
Accepted: December 18, 2007
Published online: March 13, 2008
Issue release date: April 2008

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 5

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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