In collaboration with the Hotchkiss Brain Institute, a global study recently published in JAMA from the University of Calgary shows that 1 in 5 people who have experienced a minor stroke or transient ischemic attack (TIA) will go on to have another or more severe experience within 10 years.
Approximately 795,000 Americans have a stroke every year; this number includes both new (610,000) and subsequent (185,000) events, according to the CDC. The number one cause is a blood clot forming in the arteries that are damaged by the buildup of plaques known as atherosclerosis, which can occur in the carotid artery of the neck or other arteries. This is called an ischemic stroke.
Risk factors include, but are not limited to: high blood pressure, high cholesterol, diabetes, smoking, obesity, lack of physical activity, and certain heart conditions. The American Heart Association suggests that up to 80% of these events can be prevented through healthy lifestyle changes like eating a balanced diet, exercising regularly, maintaining a healthy weight, quitting smoking, and limiting alcohol consumption, alongside managing risk factors with your healthcare professional.
“A lot of focus has been put on preventing stroke in the first 90 days post-TIA or minor stroke, which is when a person is at the highest risk of a second stroke. However, what we’re seeing in this study is that the risk continues and remains high for at least the next decade,” says Dr. Faizan Khan, PhD, postdoctoral fellow at the Cumming School of Medicine (CSM) and lead author of the study. What’s really important from these findings is that people need to stay vigilant. Attention to and treatment of risk factors, such as high blood pressure, is essential not just when people are released from hospital, but for their lifetime.”
Risks of a subsequent stroke
For this study, data from 171,068 patients who experienced a minor stroke or TIA from hospital of community-based studies across 4 continents spanning 20 countries were analyzed, to provide findings that are relevant to everyone, no matter where they live. The analysis revealed that the risks of a subsequent experience are 5.9% in the first year, 12.8% within 5 years, and 19.8% within 10 years.
“I know that adherence to medical recommendations can wane over time. People start to feel better, and the more time that passes after the first stroke, they might reconsider whether the medication and lifestyle changes are necessary,” says Dr. Michael Hill, MD, neurologist, professor at the CSM and principal investigator on the study. I hope this study serves as a bit of a wake-up call. If you know your risk is one in five of having another over 10 years, and 10 percent of those cases are fatal you may be more likely to continue the medications and lifestyle changes.”
“Along with awareness for people who have a stroke, there is also a take-away for healthcare providers,” says Khan. “Many people who experience a minor stroke or TIA see a neurologist in the hospital, and maybe once again in the first few months, but then care transfers to the community and their family doctor. Our findings should prompt healthcare providers to be mindful of the persistently high risk of a future stroke, and to consider ongoing monitoring and risk reduction strategies beyond the initial high-risk period.”
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