Secondary Stroke Prevention Lower in Elderly Patients

Study emphasizes need for secondary stroke prevention in patients of all ages

18 APRIL 2009 -- In stroke survivors, secondary prevention is essential regardless of age, according to a study published online April 16 in BMJ.
Rosalind Raine, Ph.D., of the University College London in the United Kingdom, and colleagues studied 12,830 patients aged 50 years and older who had a stroke between 1995 and 2005 and survived the first 30 days afterward.
The researchers found that secondary prevention rates were low in both men and women (25.6 percent and 20.8 percent, respectively). They also found that secondary prevention was significantly lower among patients aged 80 to 89 years than in those aged 50 to 59 years (adjusted odds ratio, 0.53), even though secondary prevention was associated with a 50 percent reduction in mortality risk in all age groups.
"The evidence suggests that concerns about the trade-off between benefits and risks in elderly people may be exaggerated and that one-year survival benefit is not modified by age," the authors write. "Therefore under-treatment of older people cannot be justified, unless it is explained by informed patient choice."
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