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Many Stroke Survivors Don't Improve Health Habits

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WEDNESDAY, Jan. 24, 2018 (HealthDay News) -- While you might think most people would try to change unhealthy behaviors after a major health scare like a stroke, new research suggests most people don't.

They may even pick up worse habits.

Fewer than 1 in 100 stroke survivors met all seven heart-health goals identified by the American Heart Association. And just 1 in 5 met four of those goals.

Dubbed "Life's Simple 7," the goals include not smoking, eating a healthy diet, getting regular physical activity, achieving a healthy weight and controlling high blood pressure, cholesterol and blood sugar levels.

The proportion of stroke survivors who met none or one of those goals grew from 18 percent in 1988-1994 to 35 percent in 2011-2014, the study found.

Over that period, obesity also increased -- from 27 percent to 39 percent. Diabetes and prediabetes rose from 49 percent to 56 percent. And the percentage of stroke survivors with a poor diet jumped from 14 percent to 51 percent.

The study did have some good news. Rates of high blood pressure and high cholesterol dropped about 19 percent and 27 percent, respectively.

"Although over the years stroke survivors have better cholesterol and blood pressure levels, stroke survivors are faring poorly with respect to their weight, diabetes control, diet and exercise," said study researcher Dr. Amytis Towfighi.

"Controlling these factors [is] critical for preventing another stroke, and improving outcomes after stroke," added Towfighi, director of neurological services at the Los Angeles County Department of Health Services.

She said the people with the lowest scores -- meeting just zero or one of the Life's Simple 7 goals -- were more likely to be poor, black and to have less than a high school education.

As to why people who've had a stroke don't seem motivated to improve their health, Towfighi said this group seems to mirror the general population.

"Specifically, blood pressure and cholesterol have improved, whereas obesity and diabetes have increased," she said.

"What was striking in this study, however, was the worsening in lifestyle behaviors, specifically diet and exercise," Towfighi said, noting there are several theories about why this is happening. Possible factors include a lack of health information, poor self-management skills and disability.

"Behavioral change is extremely hard, particularly when one has additional barriers imposed on them from the stroke -- such as disability and a lack of independence," Towfighi explained.

It wasn't clear from the study, however, how many of the people who'd had a stroke suffered an ongoing physical or mental disability.

The study included nearly 1,600 people who'd had a stroke. All were over 18 years old, and had taken part in a nationally representative survey that included almost 68,000 adults.

Dr. Shazia Alam, director of stroke services at NYU Winthrop Hospital in Mineola, N.Y., said it's good to see that high blood pressure and cholesterol levels are coming down. But, she added, it's "alarming" to learn that stroke survivors are meeting so few of the goals.

"It may be that they don't have access to care or a doctor, and if they don't have those things, they probably don't have access to a gym membership and the tools they may need to lose weight," said Alam, who wasn't part of the study.

She said the findings would help her better target stroke survivors who need extra intervention and education.

The study was scheduled to be presented Wednesday at an American Stroke Association meeting, in Los Angeles. Findings presented at meetings are typically viewed as preliminary until they've been published in a peer-reviewed journal.

More information

Learn more about the American Heart Association's Life's Simple 7.

SOURCES: Amytis Towfighi, M.D., director of neurological services, Los Angeles County Department of Health Services; Shazia Alam, D.O., director, stroke services, NYU Winthrop Hospital, Mineola, N.Y.; Jan. 24, 2018 presentation, American Stroke Association meeting, Los Angeles
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