Secondary Prevention Lags for Individuals who Experienced Stroke

In a study presented at the American Heart Association's Quality of Care & Outcomes Research Scientific Sessions 2020 (held virtually) individuals who experienced stroke were less likely to receive preventive care for atherosclerotic cardiovascular disease compared with those who had peripheral or coronary artery disease. 

The study reviewed data from14,000 adults who had peripheral or coronary artery disease or who had experienced a stroke and were enrolled in the 2006 to 2015 Medical Expenditure Panel Survey. Those who had experienced a stroke were more than 2 times as likely not to be using statins or aspirin. People with stroke were also more likely to report poor patient-provider communication, poor health care satisfaction and more emergency room visits. 

More than half of the patients were men, the average age was 65, and all had either coronary artery disease, stroke, or peripheral artery disease. These individuals were representative of nearly 16 million US adults living with one of the 3 forms of atherosclerotic cardiovascular disease.

“Our study highlights a missed opportunity for implementing life-saving preventive medications among these high-risk individuals,” Michos said. “. . .stroke should generally be treated with the same secondary prevention medications as coronary artery disease.”

“Our study highlights the need for public health campaigns to direct equal attention to all 3 major forms of atherosclerotic cardiovascular disease,” said senior study author Erin Michos, MD, MHS, associate professor of medicine at the Ciccarone Center for the Prevention of Cardiovascular Disease at The Johns Hopkins University School of Medicine in Baltimore. “We need to generate awareness among both clinicians and patients that all of these diseases should be treated with aggressive secondary preventive medications, including aspirin and statins, regardless of whether people have heart disease or not.”