Multimodal secondary prevention behavioral interventions for TIA and stroke: a systematic review and meta-analysis

PloS One
Maggie LawrenceNicola J Roberts

Abstract

Guidelines recommend implementation of multimodal interventions to help prevent recurrent TIA/stroke. We undertook a systematic review to assess the effectiveness of behavioral secondary prevention interventions. Searches were conducted in 14 databases, including MEDLINE (1980-January 2014). We included randomized controlled trials (RCTs) testing multimodal interventions against usual care/modified usual care. All review processes were conducted in accordance with Cochrane guidelines. Twenty-three papers reporting 20 RCTs (6,373 participants) of a range of multimodal behavioral interventions were included. Methodological quality was generally low. Meta-analyses were possible for physiological, lifestyle, psychosocial and mortality/recurrence outcomes. Note: all reported confidence intervals are 95%. Systolic blood pressure was reduced by 4.21 mmHg (mean) (-6.24 to -2.18, P = 0.01 I2 = 58%, 1,407 participants); diastolic blood pressure by 2.03 mmHg (mean) (-3.19 to -0.87, P = 0.004, I2 = 52%, 1,407 participants). No significant changes were found for HDL, LDL, total cholesterol, fasting blood glucose, high sensitivity-CR, BMI, weight or waist:hip ratio, although there was a significant reduction in waist circumference (-6.69 cm,...Continue Reading

References

Jun 1, 1983·Acta Psychiatrica Scandinavica·A S Zigmond, R P Snaith
Mar 1, 1997·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·G A Banet, M A Felchlia
Apr 20, 2004·Health Education & Behavior : the Official Publication of the Society for Public Health Education·Albert Bandura
Jan 18, 2006·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Jacques JoubertStephen M Davis
Aug 12, 2006·Stroke; a Journal of Cerebral Circulation·Judith RedfernCharles D A Wolfe
Dec 21, 2006·Disability and Rehabilitation·Anne Visser-MeilyEline Lindeman
Jan 24, 2007·Lancet Neurology·Kathleen StrongRuth Bonita
Nov 24, 2007·Journal of Neurology, Neurosurgery, and Psychiatry·J R SelvarajahUNKNOWN NORTHSTAR Collaborators
May 10, 2008·BMJ : British Medical Journal·Anthony Dixon
May 30, 2008·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·M Sharma
Jul 23, 2009·BMJ : British Medical Journal·David MoherUNKNOWN PRISMA Group
Nov 11, 2009·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Kyle AllenDenise Kropp
Jul 30, 2010·Age and Ageing·Katja Adie, Martin A James
Dec 7, 2010·Journal of the American Academy of Nurse Practitioners·Michelle Van Nes, Jo-Ann V Sawatzky
Dec 29, 2010·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Nete HornnesGudrun Boysen
Jan 5, 2011·Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine·Ronan O'CarrollMartin Dennis
Apr 2, 2011·Stroke; a Journal of Cerebral Circulation·Keerthi M MohanAndrew P Grieve
Mar 13, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·Maggie LawrenceJon Godwin
Mar 13, 2013·European Journal of Preventive Cardiology·Olive LennonCatherine Blake
May 18, 2013·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·James FaulknerGerard McGonigal
Jul 25, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Maggie LawrenceElizabeth Crawford
Aug 21, 2013·Hospital Practice·Kelly D FlemmingRobert D Brown
Sep 12, 2013·BMJ : British Medical Journal·Tammy C HoffmannPaul P Glasziou
Dec 1, 2011·Translational Behavioral Medicine·Teresa M DamushLinda S Williams
Jan 5, 2014·Stroke; a Journal of Cerebral Circulation·Bin PengUNKNOWN SMART Investigators
May 3, 2014·Stroke; a Journal of Cerebral Circulation·Walter N KernanUNKNOWN American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and
Jul 17, 2014·Journal of Family Nursing·Ulrika Ostlund, Carina Persson

❮ Previous
Next ❯

Citations

Nov 30, 2016·BMC Neurology·Yahira Rossini Guzmán SabogalMaría Catalina Gómez Guevara
Jan 4, 2017·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Rikke Steen KrawcykChristina Kruuse
Feb 25, 2017·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Jennifer L WessolAn-Lin Cheng
Feb 21, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Michael BraininAnita Wiseman
May 11, 2017·Stroke; a Journal of Cerebral Circulation·Joel Salinas, Lee H Schwamm
Jul 26, 2019·Disability and Rehabilitation·Nicholas GeldensHeidi Janssen
Jul 30, 2019·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Jennifer L WessolKarin E Olds
Aug 17, 2019·Journal of Evaluation in Clinical Practice·Judith A CoombesNeil W Cottrell
Feb 24, 2016·PloS One·Anna NorlanderSusanne Iwarsson
Jul 4, 2020·Acta Neurologica Scandinavica·Jacob LiljehultTom Møller
Dec 20, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Mahesh Pundlik KateUNKNOWN SPRINT India Collaborators
Mar 14, 2017·Disability and Rehabilitation·Steven G FauxLinda A Klein
May 5, 2017·The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses·Anne OikarinenMaria Kääriäinen
Feb 21, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Jacques JoubertGraeme J Hankey
Feb 23, 2019·Preventing Chronic Disease·Ryan R BaileyDebra Haire-Joshu
Jun 27, 2019·European Stroke Journal·Bo NorrvingValeria Caso
Dec 10, 2020·Disability and Rehabilitation·Hanneke E M BraakhuisJ B J Bussmann
Jun 30, 2021·The Cochrane Database of Systematic Reviews·David H SaundersCoralie English

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

Cochrane Risk of Bias
Euroaction
Review Manager
RefWorks

Related Concepts

Related Feeds

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.