No significant effect was found on cardiovascular events , mortality , diastolic blood pressure , or cholesterol .
Conclusions — We found that lifestyle interventions are effective in lowering systolic blood pressure .
About other end points , this systematic review found no effect of lifestyle interventions on cardiovascular event rate mortality , diastolic blood pressure , or total cholesterol
Background and Purpose — Patients with a transient ischemic attack or ischemic stroke have an increased risk of subsequent cardiovascular events .
The purpose of this systematic review and meta- analysis was to determine whether lifestyle interventions focusing on behaviorally modifiable risk factors with or without an exercise program are effective in terms of ( 1 ) preventing recurrent cardiovascular events , ( 2 ) reducing mortality , and ( 3 ) improving modifiable risk factors associated with cardiovascular disease in patients after a transient ischemic attack or ischemic stroke .
Long-term survival and vascular event risk after transient ischaemic attack or minor ischaemic stroke: a cohort study
BACKGROUND Determinants of survival and of risk of vascular events after transient ischaemic attack ( TIA ) or minor ischaemic stroke are not well defined in the long term . We aim ed to re study these risks in a prospect i ve cohort of patients after TIA or minor ischaemic stroke ( Rankin grade < or = 3 ) , after 10 years or more . METHODS We assessed the survival status and occurrence of vascular events in 2473 participants of the Dutch TIA Trial ( recruitment in 1986 - 89 ; arterial cause of cerebral ischaemia ) . We included 24 hospitals in the Netherl and s that recruited at least 50 patients . Primary outcomes were all-cause mortality and the composite event of death from all vascular causes , non-fatal stroke , and non-fatal myocardial infa rct ion . We assessed cumulative risks by Kaplan-Meier analysis and prognostic factors with Cox univariate and multivariate analysis . FINDINGS Follow-up was complete in 2447 ( 99 % ) patients . After a mean follow-up of 10.1 years , 1489 ( 60 % ) patients had died and 1336 ( 54 % ) had had at least one vascular event . 10-year risk of death was 42.7 % ( 95 % CI 40.8 - 44.7 ) . Age and sex-adjusted hazard ratios were 3.33 ( 2.97 - 3.73 ) for age over 65 years , 2.10 ( 1.79 - 2.48 ) for diabetes , 1.77 ( 1.45 - 2.15 ) for claudication , 1.94 ( 1.42 - 2.65 ) for previous peripheral vascular surgery , and 1.50 ( 1.31 - 1.71 ) for pathological Q waves on baseline electrocardiogram . 10-year risk of a vascular event was 44.1 % ( 42.0 - 46.1 ) . After falling in the first 3 years , yearly risk of a vascular event increased over time . Predictive factors for risk of vascular events were similar to those for risk of death . INTERPRETATION Long-term secondary prevention in patients with cerebral ischaemia still has room for further improvement
No significant effect was found on cardiovascular events , mortality , diastolic blood pressure , or cholesterol .
Conclusions — We found that lifestyle interventions are effective in lowering systolic blood pressure .
About other end points , this systematic review found no effect of lifestyle interventions on cardiovascular event rate mortality , diastolic blood pressure , or total cholesterol
Background and Purpose — Patients with a transient ischemic attack or ischemic stroke have an increased risk of subsequent cardiovascular events .
The purpose of this systematic review and meta- analysis was to determine whether lifestyle interventions focusing on behaviorally modifiable risk factors with or without an exercise program are effective in terms of ( 1 ) preventing recurrent cardiovascular events , ( 2 ) reducing mortality , and ( 3 ) improving modifiable risk factors associated with cardiovascular disease in patients after a transient ischemic attack or ischemic stroke .