CAN LIFESTYLE MODIFICATION HELP CONTROL RISK FACTORS IN PATIENTS WITH TRANSIENT ISCHEMIC ATTACKS OR MINOR STROKES?: A PILOT STUDY AND PROPOSAL FOR A MULTICENTRE TRIAL

Management of risk factors is extremely important for patients who have had a previous transient ischemic attack (TIA) or stroke, since approximately 15-20 percent of strokes are preceded by a TIA . However, literature suggests that risk factors are poorly controlled in these patients. Two studies in this population found anywhere from 25-60 percent of hypertensives have uncontrolled blood pressure, less than 50 percent of patients with hyperlipidemia have target cholesterol levels, 60-75 percent of diabetics Ag CA have inadequate glucose control, and 35 percent of patients are smokers ’ . Interventions aimed at lifestyle modification are becoming the focus of preventive efforts as patients under medical treatment are still left with poorly controlled risk factors. The objective of this study was to investigate whether the addition of a behavioural counselling support intervention in addition to standard care would improve risk factor control in patients with a previous TIA or stroke. The primary outcome of the study was blood pressure control. We conducted a randomized controlled pilot study. Fourty-eight patients were randomized to receive either standard care or standard care plus additional monitoring of risk factors by either a nurse or a volunteer. The preliminary results have provided a more valid sample size estimate for a multicentre trial. A sample size of 1086 (362 per group) will be adequate. It is projected that a multicentre trial could be completed in 3 years. This trial would help further our knowledge of the barriers to risk factor control in patients with a previous TIA or stroke and help guide the development of effective strategies for their control in this population.

Name thesis:degree_name

M Sc

Discipline thesis:degree_discipline

Epidemiology and Biostatistics

Year dc:date.issued

2006

Author dc:creator

• Bornstein, Michelle

Advisors dc:contributor.advisor

• Robertson, James
• Hachinski, Vladimir

• Stroke
• TIA
• transtheoretical model
• stages of change
• health behaviour change
• secondary prevention
• risk factor reduction

Handle dc:identifier.uri

https://hdl.handle.net/20.500.14721/20228

OAI identifier oai:identifier

oai:uwo.scholaris.ca:20.500.14721/20228