Recurrent Stroke: Risk Factors, Control and Interactions

Efforts to prevent stroke and to decrease the chance of a recurrent stroke may depend largely upon the control of associated medical conditions such as hypertenstion, arrhythmia and diabetes. However, the precise roles of various medical conditions, convariates and their interactions in relation to stroke occurrence and recurrence have not, as yet, been determined. The risk factors to be studied are diastolic and systolic blood pressure, diabetes, myocardial infarction, arrhythmia and transient ischemic attack. Age and sex will be used as covariates. Level of control of risk factors will be measured as ordinal and ratio variables. Construction and use of a model of the likelihood of recurrent stroke which allows for the simultaneous examination of risk factors and their interactions are major goals of the proposed project. The study will follow all patients who give informed consent from a large, well-defined catchment area whose initial stroke required hospitalization. Approximately 85-95% of the population in the Lehigh Valley, PA-NJ, are hospitalized subsequent to a stroke. Post-stroke follow-up observations, including the level of control of risk factors, will be made three times per year. The expected number of study subjects is between 950 and 1055. The average length of follow-up will be three and one-half years