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American Heart Association

Clinical Articles, Lead Article

Focus on top risk factors for stroke and dementia “pays off”

Fewer people died or needed expensive long-term care when their physicians focused on the top risk factors for stroke and dementia, according to research reported in the Journal of the American Heart Association (JAHA).1

The primary care doctors in the German study focused on hypertension, smoking, high cholesterol, diabetes, AF and depression. The researchers found that during a five-year period, the need for long-term care was cut 10% in women and 9.6% in men.

Based on data collected in a comparison district, 2,112 deaths were expected in the intervention group, but only 1,939 patients died.

“Primary prevention pays off,” said Dr Horst Bickel, lead author of the study (Department of Psychiatry, Technical University of Munich, Germany). “Prevention measures have a potential for improving health in old age which has up to now not been satisfactorily exploited.”

He described these as “relatively simple” interventions, such as encouraging patients to:

  • be more physically active;
  • eat healthier foods;
  • quit smoking;
  • reduce high blood pressure and high cholesterol.

The study included nearly 4,000 people age 55 and older in rural Upper Bavaria, Germany. Their family doctors were given a brochure summarizing the recommendations, treatment guidelines and goals. Those patients were compared to 13,000 people in a nearby area who received the usual care without the focus on preventing stroke and dementia.

“We found that not only the risk of long-term care dependence was lower, but also that death rates decreased,” Bickel said. “In addition, the cost of inpatient treatment was reduced in the intervention region.”

“At the population level, even simple measures can lead to substantial achievements,” he said. “Our results are only one example for how health risks can be reduced through uncomplicated, routine treatment of risk factors in the framework of a real-world setting.”

References

1. Bickel H, Ander KH, Brönner M. Reduction of long‐term care dependence After an 8‐year primary care prevention program for stroke and dementia: the INVADE trial. J Am Heart Assoc 2012;1:e000786.  http://dx.doi.org/10.1161/​JAHA.112.000786/

Published on: July 24, 2012

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