{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T13:35:41Z","timestamp":1791034541495,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,9,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Limited long-term follow-up data exist on the impact of appropriate secondary prevention therapies on cognitive function in patients after first-ever stroke. The aim of this study is to determine the effect of secondary prevention of vascular events on cognitive function after stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Data were collected between 1995 and 2011 (n=4413) from the community-based South London Stroke Register covering an inner-city multiethnic source population of 271 817 inhabitants. Modified Poisson regression models were constructed to adjust for cognitive function status at 3 months, demographic and socioeconomic characteristics, case mix, stroke subtype, vascular risk factors, disability, and stroke recurrence. In patients with ischemic strokes without a history of atrial fibrillation (AF), there was a reduced risk of cognitive impairment associated with the use of different prevention treatments: (1) antihypertensives (relative risk, 0.7 [95% confidence interval, 0.57\n                      <jats:bold>\u2013<\/jats:bold>\n                      0.82] for diuretics; relative risk, 0.8 [95% confidence interval, 0.64\n                      <jats:bold>\u2013<\/jats:bold>\n                      0.98] for angiotensin-converting enzyme inhibitors; and relative risk, 0.7 [95% confidence interval, 0.55\n                      <jats:bold>\u2013<\/jats:bold>\n                      0.81] for their combination), (2) a combination of aspirin and dipyridamole (relative risk, 0.8 [95% confidence interval, 0.68\n                      <jats:bold>\u2013<\/jats:bold>\n                      1.01]), and (3) statin (relative risk, 0.9 [95% confidence interval, 0.76\n                      <jats:bold>\u2013<\/jats:bold>\n                      1.06]) when clinically indicated. Protective effects against cognitive impairment were also observed in patients on the combination of antihypertensives, antithrombotic agents, and lipid-lowering drugs (relative risk, 0.55 [95% confidence interval, 0.40\n                      <jats:bold>\u2013<\/jats:bold>\n                      0.77]). No significant associations were noted between poststroke cognitive impairment and antihypertensives among hemorrhagic stroke patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Appropriate vascular risk management was associated with a long-term reduced risk of cognitive impairment. Focus on optimal preventive drug therapy of vascular risk factors and management should be supported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.113.002236","type":"journal-article","created":{"date-parts":[[2013,8,10]],"date-time":"2013-08-10T00:32:30Z","timestamp":1376094750000},"page":"1341-1348","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":86,"title":["Long-Term Effects of Secondary Prevention on Cognitive Function in Stroke Patients"],"prefix":"10.1161","volume":"128","author":[{"given":"Abdel","family":"Douiri","sequence":"first","affiliation":[{"name":"From the Division of Health and Social Care, King\u2019s College London, London, UK; and National Institute for Health Research Biomedical Research Centre, Guy\u2019s and St. Thomas\u2019 NHS Trust and King\u2019s College London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"McKevitt","sequence":"additional","affiliation":[{"name":"From the Division of Health and Social Care, King\u2019s College London, London, UK; and National Institute for Health Research Biomedical Research Centre, Guy\u2019s and St. Thomas\u2019 NHS Trust and King\u2019s College London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva S.","family":"Emmett","sequence":"additional","affiliation":[{"name":"From the Division of Health and Social Care, King\u2019s College London, London, UK; and National Institute for Health Research Biomedical Research Centre, Guy\u2019s and St. Thomas\u2019 NHS Trust and King\u2019s College London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony G.","family":"Rudd","sequence":"additional","affiliation":[{"name":"From the Division of Health and Social Care, King\u2019s College London, London, UK; and National Institute for Health Research Biomedical Research Centre, Guy\u2019s and St. Thomas\u2019 NHS Trust and King\u2019s College London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles D.A.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"From the Division of Health and Social Care, King\u2019s College London, London, UK; and National Institute for Health Research Biomedical Research Centre, Guy\u2019s and St. Thomas\u2019 NHS Trust and King\u2019s College London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(05)70221-0"},{"key":"e_1_3_4_3_2","volume-title":"The Atlas of Heart Disease and Stroke","author":"Mackay J","year":"2007","unstructured":"Mackay J, Mensah GA. 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