Abstract Introduction Long-term adherence to secondary prevention after ischemic stroke remains unclear. This study aimed to evaluate medication adherence, attainment of vascular treatment targets, and clinical characteristics that influence target achievement 3 years post-stroke. Patients and methods We included 665 home-dwelling ischemic stroke patients from the Norwegian Cognitive Impairment After Stroke study, admitted between May 2015 and March 2017 (n = 431 were followed for 3 years). Medication adherence was assessed using the 4-item Morisky Medication Adherence Scale, medication persistence, and guideline-based treatment targets: blood pressure (BP) 140/90 mmHg, LDL cholesterol (LDL-C) 2.0 mmol/L, and hemoglobin A1c (HbA1c) ⩽ 53 mmol/mol. Results At discharge, prescription rates were 97% for antithrombotics, 67% for antihypertensives, 88% for lipid-lowering drugs (LLD), and 10% for antidiabetics. Three years later, persistence rates were 97%, 91%, 83%, and 94%, respectively, with 73% reporting high medication adherence. Target achievement rates were 42% for BP, 47% for LDL-C, and 75% for HbA1c among diabetic patients. Younger age was associated with better BP control (OR 0.974 per year, 95% CI 0.957–0.992). Women had poorer LDL-C control (OR 0.55, 95% CI 0.33–0.91). More LLD (OR 1.25, 95% CI 1.14–1.37) and higher comorbidity (OR 1.26, 95% CI 1.10–1.44) were associated with improved LDL-C control. Conclusion Control of risk factors remained unsatisfactory 3 years after ischemic stroke, despite relatively high persistence and adherence rates. Improved focus on implementing optimal secondary prevention for Norwegian stroke patients is necessary.
Fagerli et al. (2026) studied this question.