Vascular risk factors after stroke in the older people: a population-based study.
6 affiliations
- 1Hospital Universitari Vall d´Hebron. Neurology Department, Barcelona, Spain.
- 2Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain.
- 3Stroke Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, Barcelona, Spain. [email protected].
- 4Nora Health, Barcelona, Spain.
- 5Vall d'Hebron Institut de Recerca, Recerca en Ictus, Barcelona, Spain.
- 6Agència de Qualitat i Avaluació Sanitàries de Catalunya, PADRIS, Barcelona, Spain.
Abstract
Background
The risk of recurrent stroke can be reduced by controlling modifiable risk factors such as hypertension, hypercholesterolemia, and diabetes. We aim to assess control of these key factors in a representative cohort of stroke survivors residing in Catalonia, Spain. The analysis was conducted according to the current European Stroke Organisation (ESO) guidelines, with special emphasis on an older population.Methods
An observational, retrospective, longitudinal study was conducted using data from the population-based database of the Health Quality and Assessment Agency of Catalonia. Patients diagnosed with ischemic stroke or transient ischemic attack (TIA) between 2014 and 2019 were included. Follow-up data comprised all measurements recorded during the first year after the index event. Data were collected on blood pressure, cholesterol, and HbA1c levels, as well as on pharmacological treatment, including antithrombotic agents. A comparative analysis was performed across age groups, focusing particularly on older people (> 67 years) and very older people (> 87 years) stroke survivors. In total, 35,918 patients were included in the analysis.Results
Of 35,918 included patients, 54% were men and the median age was 77 years (IQR 68-88); 9336 (23%) were older than 87 years. During the first year after stroke, blood pressure data were available for 63% of patients. Among them, 49% of individuals aged 18-67 years and 42% of the very older people achieved the target of < 130 mmHg. Despite blood tests with total cholesterol were available for 59%, LDL-cholesterol was specifically assessed only in 5% of patients, with 31% of the younger group and 35% of the very older people reaching the < 70 mg/dL target. Among patients with diabetes, HbA1c was assessed in 84%, and 81% of younger versus 83% of older people met the < 7% target. The prevalence of atrial fibrillation increased significantly with age; however, older people were less likely to receive oral anticoagulants (63% vs. 72-73%).Conclusion
A substantial proportion of stroke survivors did not achieve the targets recommended by the ESO for secondary prevention. In the older people population, fewer patients reached optimal blood pressure control, and anticoagulant use among those with atrial fibrillation was suboptimal. Our findings highlight the need for structured post-stroke follow-up pathways, improved communication between stroke specialists and primary care physicians, and targeted interventions to optimize cardiovascular risk factor management in older people.
Related
- Ischemic Stroke Associated With Vertebral Artery Occlusion Following Cervical Spine Manipulation in a Young Woman With Underlying Vascular Risk Factors: A Case Report.
- Exploratory cluster analysis of noninvasive vascular measures reveals heterogeneous vascular profiles after stroke
- Impact of early severity of finger paresis on upper limb motor recovery and functional outcomes in people after stroke: a retrospective cohort study
- Supportive Strides: Co-designing Community-Based Walking Programs with Embedded Socialisation and Peer Support for People after Stroke
- Triangulating population, individual, and genetic evidence for priority setting in structurally heterogeneous blocs: metabolic risk factors for stroke in the Shanghai Cooperation Organisation
BibTeX
@article{achutegui2026vascular,
title = {{Vascular risk factors after stroke in the older people: a population-based study.}},
author = {Maider Iza Achutegui and Federica Rizzo and Marta Olive-Gadea and Jordi Brunet and Giorgio Colangelo and Marián Muchada and Renato Simonetti and Didier Dominguez and David Cano and Marc Rodrigo-Gisbert and Alvaro García-Tornel and Manuel Requena and Noelia Rodriguez-Villatoro and Jesus Juega and David Rodríguez-Luna and Jorge Pagola and Marc Ribo and Carlos Molina and Marta Rubiera},
journal = {BMC geriatrics},
year = {2026},
month = jul,
doi = {10.1186/s12877-026-08023-3},
url = {https://europepmc.org/article/MED/42907775},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Vascular risk factors after stroke in the older people: a population-based study.
AU - Maider Iza Achutegui
AU - Federica Rizzo
AU - Marta Olive-Gadea
AU - Jordi Brunet
AU - Giorgio Colangelo
AU - Marián Muchada
AU - Renato Simonetti
AU - Didier Dominguez
AU - David Cano
AU - Marc Rodrigo-Gisbert
AU - Alvaro García-Tornel
AU - Manuel Requena
AU - Noelia Rodriguez-Villatoro
AU - Jesus Juega
AU - David Rodríguez-Luna
AU - Jorge Pagola
AU - Marc Ribo
AU - Carlos Molina
AU - Marta Rubiera
PY - 2026
DA - 2026/07/01
JO - BMC geriatrics
DO - 10.1186/s12877-026-08023-3
UR - https://europepmc.org/article/MED/42907775
AB - Background The risk of recurrent stroke can be reduced by controlling modifiable risk factors such as hypertension, hypercholesterolemia, and diabetes. We aim to assess control of these key factors in a representative cohort of stroke survivors residing in Catalonia, Spain. The analysis was conducted according to the current European Stroke Organisation (ESO) guidelines, with special emphasis on an older population.Methods An observational, retrospective, longitudinal study was conducted using data from the population-based database of the Health Quality and Assessment Agency of Catalonia. Patients diagnosed with ischemic stroke or transient ischemic attack (TIA) between 2014 and 2019 were included. Follow-up data comprised all measurements recorded during the first year after the index event. Data were collected on blood pressure, cholesterol, and HbA1c levels, as well as on pharmacological treatment, including antithrombotic agents. A comparative analysis was performed across age groups, focusing particularly on older people (> 67 years) and very older people (> 87 years) stroke survivors. In total, 35,918 patients were included in the analysis.Results Of 35,918 included patients, 54% were men and the median age was 77 years (IQR 68-88); 9336 (23%) were older than 87 years. During the first year after stroke, blood pressure data were available for 63% of patients. Among them, 49% of individuals aged 18-67 years and 42% of the very older people achieved the target of < 130 mmHg. Despite blood tests with total cholesterol were available for 59%, LDL-cholesterol was specifically assessed only in 5% of patients, with 31% of the younger group and 35% of the very older people reaching the < 70 mg/dL target. Among patients with diabetes, HbA1c was assessed in 84%, and 81% of younger versus 83% of older people met the < 7% target. The prevalence of atrial fibrillation increased significantly with age; however, older people were less likely to receive oral anticoagulants (63% vs. 72-73%).Conclusion A substantial proportion of stroke survivors did not achieve the targets recommended by the ESO for secondary prevention. In the older people population, fewer patients reached optimal blood pressure control, and anticoagulant use among those with atrial fibrillation was suboptimal. Our findings highlight the need for structured post-stroke follow-up pathways, improved communication between stroke specialists and primary care physicians, and targeted interventions to optimize cardiovascular risk factor management in older people.
SN - 1471-2318
ER -