Lifestyles correlate with stroke recurrence in Chinese inpatients with first-ever acute ischemic stroke

• Published in: Journal of neurology 2019-05, Vol.266 (5), p.1194-1202
• Main Authors: Huang, Zhi-Xin, Lin, Xiao-Ling, Lu, Hai-Ke, Liang, Xiao-Yu, Fan, Li-Juan, Liu, Xin-Tong
• Format: Article
• Language: English
• Subjects: Cholesterol; Coronary artery disease; Drug addiction; Etiology; Fruits; Health risk assessment; Heart diseases; High density lipoprotein; Ischemia; Lifestyles; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosciences; Original Communication; Risk factors; Sleep; Stroke
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-019-09249-5

Objectives The previous studies have shown that recurrent stroke (RS) adversely affects the life of survivors of ischemic stroke (IS). However, lifestyle associated with RS has received a little systematic study in Chinese Han patients. We aimed to perform a comprehensive assessment of lifestyle and the potential risk factors associated with RS in Chinese Han inpatients with first-ever acute ischemic stroke by conducting a long-term follow-up. Methods Using a prospective and longitudinal design, we recruited 421 patients with first-ever acute ischemic stroke who were consecutively admitted to the Acute Stroke Unit between November 2012 and January 2014. Demographic data, vascular risk factors, previous Rankin scale score, and etiology were collected at study intake. Multivariable Cox regression model was used to investigate the influencing factors for RS. Results Fifty-seven (13.5%) patients experienced RS during the 1-year follow-up period. Multivariable Cox regression analysis revealed that smoking [hazard ratio (HR), 2.153; 95% confidence interval (CI), 1.263–3.671], high-density lipoprotein cholesterol (HDL) (HR 0.438; 95% CI 0.211–0.911), housework (HR 0.488; 95% CI 0.256–0.933), ischemic heart disease (IHD) (HR 2.998; 95% CI 1.281–7.020), daily consumption of fresh fruits (HR 0.477; 95% CI 0.278–0.819), and good sleep quality (HR 0.375; 95% CI 0.216–0.650) were associated with RS among stroke patients. Conclusions Our results suggest that healthy lifestyle (high fruit intake, smoking cessation, housework, and good sleep quality), higher HDL levels, and lack of IHD may be associated with a lower risk of RS in patients with first-onset IS.