Effect of socioeconomic status on secondary prevention of stroke

OBJECTIVE: Cardiovascular risk factors increase risk for stroke recurrence. Secondary prevention of stroke may be affected not only by established risk factors, but also socioeconomic status. This study evaluates relationships between socioeconomic status and cardiovascular and behavioral factors. DESIGN: Cross-section study. SETTING: Public Health and Education Institute, Peking University. PARTICIPANTS: Outpatients (n = 2354) with a past diagnosis of stroke or transient ischemic attack. INTERVENTION(S): The investigation consisted of a questionnaire regarding patients' socioeconomic and living status, and a clinical examination at the research center. MAIN OUTCOME MEASURE(S): Control rates of risk factors for cardiovascular disease. RESULTS: With regard to hypertension patients, 67.0% were aware of having hypertension, 63.6% were treated and 53.9% had controlled hypertension; for patients with hypercholesterolemia, 46.7% were aware of having hypercholesterolemia, 38.6% were treated and 3.8% had controlled hypercholesterolemia; for patients with diabetes mellitus, 28.0% were aware of having diabetes mellitus, 25.7% were treated and 3.5% had controlled diabetes mellitus. After multivariate analysis, education was the strongest associated factor for controls of hypertension and diabetes mellitus. After adjustment for sex and age, strong and graduated relationships were noted between the level of education and control of risk factors, with the odds ratios increasing at every increment. CONCLUSION: Education exerts the most important effect on the control of established cardiovascular risk factors; Successful intervention to reduce these risk factors will have to be addressed, not just with regard to specific risk factors, but also with the societal conditions that lead to the adoption and maintenance of high-risk behaviors.