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Title: Risk awareness in secondary stroke prevention
Author: Slark, Julia Suzanne
ISNI:       0000 0004 0132 8497
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2012
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Stroke is the single largest cause of disability and second highest cause of death globally. It is estimated that 10 million people a year are affected by stroke in the United Kingdom (UK). Of the 130,000 annual new stroke occurrences in the UK, one third will go on to have a further stroke. Recurrent stroke is more likely to be fatal than first stroke and survivors are more likely to be left with major disability. Many stroke patients do not adhere to secondary prevention strategies due to complex reasons, including lack of appreciation of their high risk of a secondary cardiovascular event. Long-term secondary prevention remains a desired goal in the management of stroke survivors, however, studies have shown that current strategies are not routinely and universally working. Hypothesis: Raising awareness of secondary stroke risk may improve stroke survivor’s adherence to secondary prevention strategies after stroke. Results: A survey of the general public (n=1019) and a population-based study of over 600 stroke survivors found that knowledge about Blood Pressure (BP) and stroke risk factors was poor in high risk populations. Only 55% of stroke survivors were able to cite any well-known vascular risk factors. However, those who were appropriately risk-aware significantly improved their health behaviour post-stroke by consuming less alcohol (P<0.001), less salt (P=0.05) and eating a healthy diet (P=0.02). Further, In a Randomised Controlled Trial setting an intervention to increase risk awareness was successful in increasing awareness (P=0.04) and resulted in a significant increase in knowledge of stroke sub-type (95% CI 0.72-0.677, P<0.001), risk factor control of systolic BP (95% CI 12.1-10.4, P=0.01) and increased the number of healthy lifestyle behaviour changes made at follow-up (P<0.001). Conclusions: Increasing risk awareness is potentially an important mechanism to improve health behaviour following stroke and may improve risk factor control as part of secondary stroke prevention.
Supervisor: Sharma, Pankaj Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral