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

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Abstract

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.

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Acknowledgements

This work was partially supported by the Science and Technology Program of Guangzhou, China (201707010436), Guangdong Second Provincial General Hospital Medical Scientific Research Projects (YY2016-005), and Administration of Traditional Chinese Medicine of Guangdong Province, China (20173024; 20181012). We want to thank Xiang Yang Zhang of the University of Texas Health Science Center at Houston for her advice on Methods and Results sections.

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Authors and Affiliations

  1. Department of Neurology, Guangdong Second Provincial General Hospital, 466 Middle Xingang Road, Guangzhou, 510317, Guangdong, China

    Zhi-Xin Huang, Hai-Ke Lu, Xiao-Yu Liang & Xin-Tong Liu

  2. Center for Cerebrovascular Diseases, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China

    Zhi-Xin Huang, Hai-Ke Lu, Xiao-Yu Liang & Xin-Tong Liu

  3. Department of Neurology, Affiliated Nanyue Hospital, Southern Medical University, Guangzhou, Guangdong, China

    Zhi-Xin Huang, Hai-Ke Lu, Xiao-Yu Liang & Xin-Tong Liu

  4. School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China

    Xiao-Ling Lin

  5. Department of Neurology, Beijing Armed Police Corps Hospital, Beijing, China

    Li-Juan Fan

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  1. Zhi-Xin Huang
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Correspondence to Zhi-Xin Huang.

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The study protocol was approved by the Ethical Committee of the Guangdong Second Provincial General Hospital, and conformed to the ethical guidelines of the 1975 Declaration of Helsinki, with all participants in this study providing written informed consent.

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Huang, ZX., Lin, XL., Lu, HK. et al. Lifestyles correlate with stroke recurrence in Chinese inpatients with first-ever acute ischemic stroke. J Neurol 266, 1194–1202 (2019). https://doi.org/10.1007/s00415-019-09249-5

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