There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .
[Cardiovascular morbimortality reduction after an acute cardiovascular event through multifactorial and intensive cardiovascular risk factors management (MIRVAS project)].
BACKGROUND AND OBJECTIVE In spite of publication of many guidelines , management of patients on secondary prevention of cardiovascular disease is still not appropriated . We design a r and omized trial , in usual clinical practice conditions , to compare the results in cardiovascular morbimortality of intensive and integral management of cardiovascular risk factors ( CVRF ) management versus conventional care . PATIENTS AND METHOD We selected patients discharged between October 2002 and January 2004 who suffered an acute coronary syndrome with or without ST-segment elevation or a stroke , 247 patients that met inclusion s criteria were r and omized to intensive care of CVRF  in a specific Internal Medicine outpatient clinic ( n = 121 ) or usual care according to National Health Service recommendations ( n = 126 ) . A year after r and omization , the percentage of patients who met CVRF control , treatment received and the number of cardiovascular events ( cardiovascular death , acute coronary syndrome with or without ST-segment elevation , stroke , transient ischemic attack , revascularization , lower limb amputation , heart failure admission and sudden death ) were revised . RESULTS CVRF control was greater in patients assigned to intensive care . 74.1 % of hypertensive patients assigned to this treatment were controlled vs 41.7 % in the usual care group ( relative risk [ RR ] = 1.78 ; 95 % confidence interval [ CI ] , 1.27 - 2 - 49 ) ; 70.2 % of patients had low-densi-tiy lipoprotein cholesterol lower than 100 mg/dl vs 55.8 % ( RR = 1.26 ; 95 % CI , 1.00 - 1.58 ) of patients in usual care group ; 93.1 % of diabetic patients had glycosylated haemoglobin lower than 7 % vs. 57.1 % ( RR = 1.63 ; 95 % CI , 1.11 - 2.39 ) in the usual care group . There were 12 cardiovascular events in the intensive care group vs 35 in the usual care group . CONCLUSIONS Intensive management of CVRF leads to a better control of them and a reduction of the morbimortality one year after an acute cardiovascular event
There were no significant effects of organisational  interventions on lipid profile , HbA1c , medication adherence or recurrent cardiovascular events .
Pooled results indicated that educational interventions were not associated with clear differences in any of the review outcomes .
The estimated effects of organisational interventions were compatible with improvements and no differences in several modifiable risk factors .
BACKGROUND People with stroke or transient ischaemic attack ( TIA ) are at increased risk of future stroke and other cardiovascular events .
Evidence -based strategies for secondary stroke prevention have been established .
However , the implementation of prevention strategies could be improved .
OBJECTIVES To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on modifiable risk factor control , including patient adherence to prescribed medications , and the occurrence of secondary cardiovascular events .