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2014 | 10 | 1 |

Article title

Trends in the treatment of risk factors for stroke in a Czech stroke unit


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The goal of this study is to evaluate therapeutic
trends for several diseases that represent risk factors for
stroke. The relative frequency of therapy with compounds
that influence the risk factors for stroke was monitored
in a group of 3,290 patients who were hospitalised in the
Stroke Unit at the University Hospital in Hradec Kralove
between 2005 and 2012. For most drugs monitored, the
reasons for the significant decrease or increase in use were
causes other than the reduction of stroke risk. Despite this
finding, the majority of statistically significant changes
had, according to review of comparative studies, a posi-
tive effect on prevention of stroke. Motivation to change
treatment of stroke risk factors, such as hypertension,
diabetes mellitus and hypercholesterolemia, was mainly
aimed at sufficient disease management with a minimum
of adverse effects. On the other hand, optimization of
stroke recurrence and economic factors were motivations
to treatment changes in prevention with antiplatelets.
Antidiabetics were associated with an increase in met-
formin use and reduction in insulin use. For antihyperten-
sives, the most significant reduction was associated with
the use of diuretics, although calcium channel blockers
and beta-blockers are also less used. Additionally, the use
of the ACE inhibitor ramipril increased








Physical description


26 - 10 - 2015
29 - 9 - 2015
4 - 9 - 2013


  • University Hos-
    pital in Hradec Králové, Hradec Kralove, Czech Republic
  • University Hos-
    pital in Hradec Králové, Hradec Kralove, Czech Republic
  • University Hos-
    pital in Hradec Králové, Hradec Kralove, Czech Republic
  • University Hos-
    pital in Hradec Králové, Hradec Kralove, Czech Republic


  • [1] Mannami T, Baba S, Ogata J. Strong and significant relationshipsbetween aggregation of major coronary risk factorsand the acceleration of carotid atherosclerosis in the generalpopulation of a Japanese city: the Suita Study, Arch.Intern.Med., 2000, 160, 2297-2303
  • [2] Wilson PW, Hoeg JM, D’Agostino RB, Silbershatz H, BelangerAM, Poehlmann H, et al. Cumulative effects of high cholesterollevels, high blood pressure, and cigarette smoking on carotidstenosis, N. Engl. J. Med., 1997, 337, 516-522
  • [3] Harmsen P, Lappas G, Rosengren A, Wilhelmsen L. Long-termrisk factors for stroke: twenty-eight years of follow-up of 7457middle-aged men in Göteborg, Sweden, Stroke, 2006, 37,1663-1667[Crossref]
  • [4] Arvanitakis Z, Schneider JA, Wilson RS, Li Y, Arnold SE, WangZ, et al. Diabetes is related to cerebral infarction but not to ADpathology in older persons, Neurology, 2006, 67, 1960-1965
  • [5] Janghorbani M, Hu FB, Willett WC, Li TY, Manson JE, LogroscinoG, et al. Prospective study of type 1 and type 2 diabetes andrisk of stroke subtypes: the Nurses’ Health Study, DiabetesCare, 2007, 30, 1730-1735[Crossref][WoS]
  • [6] Luitse MJ, Biessels GJ, Rutten GE, Kappelle LJ. Diabetes,hyperglycaemia, and acute ischaemic stroke, Lancet Neurol.,2012, 11, 261-271[WoS][Crossref]
  • [7] Gray CS, Hildreth AJ, Sandercock PA, O’Connell JE, JohnstonDE, Cartlidge NE, et al. Glucose-potassium-insulin infusionsin the management of post-stroke hyperglycaemia: the UKGlucose Insulin in Stroke Trial (GIST-UK), Lancet Neurol., 2007,6, 397-406[WoS][Crossref]
  • [8] Tirschwell DL, Smith NL, Heckbert SR, Lemaitre RN, LongstrethWT Jr., Psaty BM. Association of cholesterol with stroke riskvaries in stroke subtypes and patient subgroups, Neurology,2004, 63, 1868-1875
  • [9] Freiberg JJ, Tybjaerg-Hansen A, Jensen JS, Nordestgaard BG.Nonfasting triglycerides and risk of ischemic stroke in thegeneral population, JAMA, 2008, 300, 2142-2152[WoS]
  • [10] Corvol JC, Bouzamondo A, Sirol M, Hulot JS, Sanchez P, LechatP. Differential effects of lipid-lowering therapies on strokeprevention: a meta-analysis of randomized trials, Arch. Intern.Med., 2003, 163, 669-676
  • [11] Amarenco P, Labreuche J. Lipid management in the preventionof stroke: review and updated meta-analysis of statins forstroke prevention, Lancet Neurol., 2009, 8, 453-463[Crossref][WoS]
  • [12] Moonis M. High-dose statins should be used in all acuteischemic strokes, Stroke, 2012, 43, 1992-1993[WoS]
  • [13] Mast H, Thompson JL, Lee SH, et al. Hypertension and diabetesmellitus as determinants of multiple lacunar infarcts. Stroke,1995, 26, 30-33[Crossref]
  • [14] Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemiccontrol and the prevention of cardiovascular events:implications of the ACCORD, ADVANCE, and VA diabetes trials:a position statement of the American Diabetes Association anda scientific statement of the American College of CardiologyFoundation and theAmerican Heart Association. Circulation,2009, 119, 351-357
  • [15] UK Prospective Diabetes Study Group. Tight blood pressurecontrol and risk of macrovascular and microvascular complicationsin type 2 diabetes: UKPDS 38. BMJ, 1998, 317, 703-713
  • [16] Colhoun HM, Betteridge DJ, Durrington PN, et al. Primaryprevention of cardiovascular disease with atorvastatin in type2 diabetes in the Collaborative Atorvastatin Diabetes Study(CARDS): multicentre randomised placebo-controlled trial.Lancet, 2004, 364, 685-696
  • [17] Joya-Galeana J, Fernandez M, Cervera A, Reyna S, Ghosh S,Triplitt C, et al. Effects of insulin and oral anti-diabetic agentson glucose metabolism, vascular dysfunction and skeletalmuscle inflammation in type 2 diabetic subjects, DiabetesMetab. Res. Rev., 2011, 27, 373-382[WoS]
  • [18] Farkas S, Molnár S, Nagy K, Hortobágyi T, Csiba L. Comparativein vivo and in vitro postmortem ultrasound assessment ofintima-media thickness with additional histological analysisin human carotid arteries. In: Bartels E, Bartels S, Poppert H.New trends in neurosonology and cerebral hemodynamics – anupdate. Perspectives in Medicine, 2012, 1, 170-176
  • [19] Scarpello JH, Howlett HC. Metformin therapy and clinical uses,Diab.Vasc. Dis. Res., 2008, 5, 157-167[Crossref]
  • [20] Katakami N, Yamasaki Y, Hayaishi-Okano R, Ohtoshi K, KanetoH, Matsuhisa M, et al. Metformin or gliclazide, rather thanglibenclamide, attenuate progression of carotid intima-mediathickness in subjects with type 2 diabetes, Diabetologia, 2004,47, 1906-1913
  • [21] Schramm TK, Gislason GH, Vaag A, Rasmussen JN, Folke F,Hansen ML, et al. Mortality and cardiovascular risk associatedwith different insulin secretagogues compared with metforminin type 2 diabetes, with or without a previous myocardialinfarction: a nationwide study, Eur. Heart. J., 2011, 32,1900-1908[WoS][Crossref]
  • [22] Li J, Benashski SE, Venna VR, McCullough LD. Effects ofmetformin in experimental stroke, Stroke, 2010, 41, 2645-52[WoS]
  • [23] Wang J, Gallagher D, DeVito LM, Cancino GI, Tsui D, He L, et al.Metformin activates an atypical PKC-CBP pathway to promoteneurogenesis and enhance spatial memory formation, CellStem Cell, 2012, 11, 23-35[WoS]
  • [24] Potts MB, Lim DA. An old drug for new ideas: Metforminpromotes adult neurogenesis and spatial memory formation,Cell Stem Cell, 2012, 11, 5-6[Crossref][WoS]
  • [25] Zeller M, Danchin N, Simon D, Vahanian A, Lorgis L, Cottin Y, etal. Impact of type of preadmission sulfonylureas on mortalityand cardiovascular outcomes in diabetic patients with acutemyocardial infarction, J. Clin. Endocrinol. Metab., 2010, 95,4993-5002[WoS]
  • [26] Amarenco P, Labreuche J. Lipid management in the preventionof stroke: review and updated meta-analysis of statins forstroke prevention. Lancet Neurol., 2009, 8, 453-463[Crossref][WoS]
  • [27] Lampl Y, Lorberboym M, Gilad R, Vysberg I, Tikozky A, Sadeh M,et al. Early outcome of acute ischemic stroke in hyperlipidemicpatients under atorvastatin versus simvastatin, Clin. Neuropharmacol.,2010, 33, 129-134[Crossref][WoS]
  • [28] Scheen AJ. The IDEAL study comparing simvastatin 20-40mg versus atorvastatin 80 mg for secondary prevention aftermyocardial infarction: between two ideas of the ideal, Rev.Med. Liege, 2006, 61, 53-59
  • [29] Karalis DG, Ross AM, Vacari RM, Zarren H, Scott R. Comparisonof efficacy and safety of atorvastatin and simvastatin in patients with dyslipidemia with and without coronary heartdisease, Am. J. Cardiol., 2002, 89, 667-671
  • [30] Lawes CM, Bennett DA, Feigin VL, Rodgers A. Blood pressureand stroke: an overview of published reviews. Stroke, 2004, 35,776-785[Crossref]
  • [31] Rashid P, Leonardi-Bee J, Bath P. Blood pressure reduction andsecondary prevention of stroke and other vascular events: asystematic review. Stroke, 2003, 34, 2741-2748[Crossref]
  • [32] Thompson AM, Hu T, Eshelbrenner CL, et al. Antihypertensivetreatment and secondary prevention of cardiovascular diseaseevents among persons without hypertension: a meta-analysis.JAMA, 2011, 305, 913-922[WoS]
  • [33] Szepesi R, Széll IK, Hortobágyi T, Kardos L, Nagy K, Lánczi IL, etal. New prognostic score for the prediction of 30-day outcomein spontaneous supratentorial cerebral haemorrhage. BiomedRes. Int., 2015, article ID 961085, doi: 10.1155/2015/961085[Crossref]
  • [34] Bosch J, Yusuf S, Pogue J, Sleight P, Lonn E, RangoonwalaB, et al. Use of ramipril in preventing stroke: double blindrandomised trial, BMJ, 2002, 324, 699-702
  • [35] Sepehrdad R, Chander PN, Oruene A, Rosenfeld L, LevineS, Stier CT Jr. Amiloride reduces stroke and renalinjury instroke-prone hypertensive rats, Am. J. Hypertens., 2003, 16,312-318[Crossref]
  • [36] Messerli FH, Makani H, Benjo A, Romero J, Alviar C, BangaloreS. Antihypertensive efficacy of hydrochlorothiazide asevaluated by ambulatory blood pressure monitoring: ameta-analysis of randomized trials, J. Am. Coll.Cardiol., 2011,57, 590-600[WoS]
  • [37] Wang J-G, Li Y, Franklin SS, Safar M. Prevention of stroke andmyocardial infarction by amlodipine and angiotensin receptorblockers. A quantitative overview, Hypertension, 2007, 50,181-188[WoS]
  • [38] Kjeldsen SE, Hedner T, Syvertsen JO, Lund-Johansen P, HanssonL, Lanke J, et al. Influence of age, sex and blood pressure onthe principal endpoints of the Nordic Diltiazem (NORDIL) Study,J.Hypertens., 2002, 20, 1231-1237[Crossref]
  • [39] Ohsfeldt RL, Kreder KJ, Klein RW, Chrischilles EA. Cost-effectivenessof tamsulosin, doxazosin, and terazosin in thetreatment of benign prostatic hyperplasia, J.Manag.Care.Pharm., 2004, 10, 412-422[Crossref]
  • [40] Chobanian AV, Bakris GL, Black HR, et al. The seventh reportof the Joint National Committee on Prevention, Detection,Evaluation, and Treatment of High Blood Pressure: the JNC 7report. JAMA, 2003, 289, 2560-2572

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