Background and Purpose-Although much is known about the long-term outcome of stroke patients in terms of mortality and disability, there has been little research on the patient-centered outcome of health-related quality of life (HRQoL).There are limited natural history data on HRQoL beyond 2 years after stroke and no data on those factors present at stroke onset that predict HRQoL beyond 2 years after stroke. For these reasons, we aimed to examine these aspects of HRQoL in an unselected population of stroke patients. Methods-All cases of first-ever stroke from a prospective community-based stroke incidence study (excluding subarachnoid hemorrhage) were assessed 5 years after stroke. HRQoL was measured with the assessment of quality of life instrument. ANOVA was used to determine baseline predictors of HRQoL. Results-In total, 978 cases were recruited, 45% were male, and the mean age (ϮSD) was 75.5Ϯ13.8 years. Five years after stroke, 441 (45.1%) were alive and 356 were assessed (80.7%). Those assessed were more often born in Australia and older in age (both PϽ0.05). Seventy-one survivors (20%) had a very low HRQoL (score Յ0.1). The independent baseline predictors of low HRQoL at 5 years after stroke were increasing age, lower socioeconomic status, and markers of stroke severity. Conclusion-At 5 years after stroke, we found that a substantial proportion of survivors were suffering from poor HRQoL.As our population ages, the number of strokes and, thus, stroke survivors with poor HRQoL is likely to increase. Therefore, strategies to improve HRQoL should be vigorously pursued.

Background and Purpose-Greater stroke mortality has been reported among lower socioeconomic groups. We aimed to determine whether fatal, nonfatal, and overall stroke incidence varied by socioeconomic status. Methods-All suspected strokes occurring in 22 postcodes (population of 306 631) of Melbourne, Australia, during a 24-month period between 1997 and 1999 were found and assessed. Multiple overlapping sources were used to ascertain cases with standard clinical definitions for stroke. Socioeconomic disadvantage was assigned in 4 bands from least to greatest using an area-based measure developed by the Australian Bureau of Statistics.

Abstract-Control of blood pressure after stroke is important for reducing the risk of recurrent stroke. We examined the control of hypertension in a community-based population of 5-year stroke survivors. Cases of first-ever stroke from the North East Melbourne Stroke Incidence Study were interviewed at 5 years poststroke. Blood pressure, history of hypertension, and antihypertensive medications were recorded. Individuals were classified as normotensive (blood pressure Ͻ140/90 mm Hg, no history of hypertension, and no antihypertensive medications), controlled hypertensive (blood pressure Ͻ140/90 mm Hg, history of hypertension, and/or taking antihypertensive medications), uncontrolled hypertensive (blood pressure Ն140/90 mm Hg, history of hypertension, and/or taking antihypertensive medications), or uninformed hypertensive (blood pressure Ն140/90 mm Hg, no known history of hypertension, and no antihypertensive medications). At 5 years poststroke, 441 (45%) of 978 first-ever stroke cases were alive. Of these, 305 (69%) had complete data on blood pressure, antihypertensive medication use, and history of hypertension. No statistical differences existed between those with or without these data. Eight-two percent were hypertensive; 63% had controlled hypertension, 30% had uncontrolled hypertension, and 7% were unaware that they were hypertensive. Overall, 67% of individuals classified as uncontrolled or uninformed hypertensive subjects were receiving treatment that was insufficient to achieve target blood pressure levels. Uncontrolled hypertensive subjects were more likely to recall receiving advice to manage their hypertension with medication (PϽ0.02) and diet (PϽ0.09). Although the majority of hypertensive individuals had controlled hypertension at 5 years poststroke, considerable improvement can be made in the control of hypertension after stroke.