2014 Volume 36 Issue 6 Pages 425-431
Background and Purpose: Although hypertension and diabetes are strong predictors for stroke, only few studies have investigated their combined impact on stroke recurrence. We investigated the relationship between clinical characteristics of the ischemic stroke patients and stroke recurrence, and their association with all-cause mortality within 2 years after onset.Methods: A total of 544 ischemic stroke patients, living in the Yamagata prefecture, were enrolled in this study. We evaluated the clinical characteristics of patients on admission, and followed their clinical courses for 2 years.Results: During mean follow up of 22.4 months, 25 incident ischemic stroke events were found. Furthermore, 34 patients died during follow up. On multivariate Cox hazard regression analyses, combination of hypertension, diabetes, hypercholesterolemia (HR 2.72, p=0.033), and past history of stroke (HR 3.69, p=0.001) were independent predictors of stroke recurrence. The results of multivariate Cox hazard regression analyses also showed that age (HR 1.05, per 1-year increase), presence of hypertension and diabetes (HR 2.99), anti-thrombotic therapy (HR 0.18), lacunar infarct (HR 0.14), cardiogenic embolism (HR 2.45), and the scores of modified Rankin scale (HR 2.75, per 1 score increase) were independent predictors of all-cause mortality.Conclusion: The results of the present study indicate that joint effects of diabetes, hypertension, and hypercholesterolemia are at increased risk for ischemic stroke recurrence. Diabetes appeared to be associated with all-cause mortality, and joint effect of hypertension and diabetes are independent risk for all-cause mortality within 2 years after the onset of ischemic stroke.
