Stroke survivors are at risk of cerebrovascular and cardiovascular complications. In Denmark
25% of stroke admissions are caused by recurrent stroke or TIA. Little is known of the risk
factors for recurrent stroke. This is being investigated in a cohort study (RIALTO) initiated
in may 2004. The PREVENT study is aimed at studying the health behavior of stroke survivors
as well as the effect of a preventive intervention aimed at risk factors associated with
hypertension. Hypertension is the main risk factor for primary stroke and the one risk factor
known to be associated with stroke recurrence.
Inclusion criteria: inclusion in the RIALTO-cohort, no severe cognitive deficits or dementia,
no other life threatening disease.
Exclusion criteria: discharge to a nursing home
Participants (n=342) are randomised to either the intervention group (n=171) or the control
group (n=171). Randomisation is performed by a computer-generated allocation schedule, with
the randomisation sequence blocked from previewing. The analyser will be blinded from the
allocation of the patients.
Baselinedata: Blood pressure, BMI and Rankin scale will be monitored few days prior to
discharge.Blood pressure will be measured according to standards set by the Danish Society of
hypertension.
Patients in the intervention group will receive a visit by a study nurse one, four, seven,
and ten months after discharge. The aim of the visits are: controlling the patient's
hypertension, reducing risk factors like tobacco smoking and obesity, motivating the patient
to physical activity and to a healthy diet as well as compliance with pharmacological
treatment of hypertension, diabetes, hypercholesterolemia and anti-thrombotic
treatment.Patients in the control group will receive the usual treatment.
This study is aimed at testing the hypothesis, that
Primary outcome: the blood pressure lowering will be greater in the intervention group
Secondary outcomes: the blood pressure will be lower in the intervention group and the number
of patients who have stopped smoking will be greater in the intervention group The number of
obese patients who have reduced their BMI will be greater in the intervention group The
number of patients with a Rankin Scale<3 who are physically active for four hours a week will
be greater in the intervention group Time to recurrent stroke, MI and death will be longer in
the intervention group
Outcomes are measured by follow up visit one and two years after inclusion in the study.
Hypertension is defined as a blood pressure > 140 mm Hg or > 90 mm Hg. The diagnosis of a
recurrent stroke will be based on a CT og MR scan or on the clinical diagnosis made by a
neurologist.MI should be confirmed by an ECG and by relevant biomarkers.
All participants will be followed up by register data for six years from inclusion as will
all participants of the RIALTO cohort.
