Risk Elements and Drug Utilization in Stroke Patients

Abstract

Objective: Cerebrovascular accident (CVA), formally called as stroke is the second leading cause of death worldwide. Recent studies in different parts of India also documented that the prevalence of stroke varies from 40 to 270 per 100,000 populations. Identifying the risk factors of the disease helps to improve the effectiveness of the therapy. Our present study aims in accessing the risk aspects and utilization of drugs in CVA patients.Methods: A prospective Interventional study was carried out on stroke patients in Medicine Department, Viswabarathi Hospital, Kurnool, AP from January to September 2015. Required demographic and laboratory data, along with general neurological evaluation and brain CT was analyzed. Results:A total of 100 patients was analyzed. Among them, the incidence of ischemic stroke (96%) was greater compared to hemorrhagic stroke (4%). Prevalence of disease was higher in males (69%) than females (31%) with notable occurrence in the age group of 61-70 (26%). Higher percentage of patients were found to have>3 risk factors (34%), including hypertension (68%), age (58%), diabetes (39%), smoking (22%), alcoholism (21%), CAD (10%) and percentage with no risk element accounts7%. The prescribing pattern includes antihypertensives (16.25%), Gastrointestinal agents (12.2%), anti-platelets (9.16%), hyperlipidemic (8.4%), Nootropics (7.97%) followed by other classes and nitrates (0.62%) occupies the last place in prescribing. Conclusion:The present study emphasizes on the need to identify risk factors and providing awareness among the patients by a pharmacist in minimizing the disease burden. It also points the rationality in prescribing of drugs based on therapeutic guidelines. Disease affecting the supply of blood to the brain is referred as stroke or Cerebrovascular diseases or apoplexy. WHO has defined a stroke as "rapidly developing clinical signs of focal or global disturbance of cerebral function, lasting for more than twenty-four hours or leading to death, with no apparent cause other than the vascular origin. Epidemiological studies state that stroke is the third leading cause of death worldwide along with coronary artery disease. A survey in different parts of India also shows that it differs from region to region, ranging from 40 to 270 per 100,000 populations [1].Based on clinical syndrome, stroke can be divided mainly as Ischemic, causing an acute occlusion of blood flow to the brain due to a thrombus of cerebral origin or from another part of circulation and hemorrhage, caused by a subarachnoid hemorrhage in brain tissues or intra-cerebral hemorrhage, i.e., between meningeal spaces. Among both 50-80% of stroke is contributed by ischemic pathophysiology. The prevalence of the disease is very much closely related to its risk factors, categorized as a) fixed risk factors (Age, Gender, Race, previous vascular event (MI, stroke, PVD), Hereditary (high Fibrinogen)) and b) Modifiable risk factors (Blood pressure, Cigarette, smoking, hyperlipidemia, Heart disease (Atrial fibrillation, Con...