Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

Age and sex related trends in the use of primary prevention medications before stroke (2007-2019) (123057)

Catherine Burns 1 , Monique F Kilkenny 1 2 , Catherine Oliver 1 , Tara Purvis 1 , Dominique A Cadilhac 1 2 , Kelvin Hill 3 , Lachlan L Dalli 1
  1. Monash University, Clayton, VICTORIA, Australia
  2. Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
  3. Stroke Foundation, Melbourne, Victoria, Australia

Background: Appropriate management of cardiovascular risk factors, including the use of pharmacotherapy, is reported to prevent >80% of strokes.

Aims: To determine the proportion of patients who used antithypertensive or lipid-lowering medications before their first-ever stroke; and compare differences over time, by sex and age.

Methods: Analysis of cross-sectional clinical data from the National Stroke Audit Acute Services (2007-2019). Demographic data, stroke presentation information (stroke type) and medical history (risk factors, use of medications, modified Rankin Scale score before admission) were collected for patients with first-ever stroke. Descriptive statistics were used to describe patient characteristics and medication use. Adjusted proportions of medication use were derived from multivariable logistic regression models, compared over time using Cochrane Armitage tests for linear trends (Ptrend), and analysed by sex and age (<65 vs ≥65 years).

Results: Of 17,944 patients with first-ever stroke (median age 74.6 years; 54.5% male), 84% had hypertension and 40% had hypercholesterolemia on admission. Significant increases were observed in the use of antihypertensive medications over time, particularly for women (all ages Ptrend=0.007, 0.4% increase/cycle; aged <65 years Ptrend=0.015, 1.1% increase/cycle). There was an increase in the use of lipid-lowering medications for men (Ptrend=0.001, 0.7% increase/cycle) and among all patients aged <65 years (Ptrend<0.001, 1.7% increase/cycle). There was a decrease in the use of lipid-lowering medications for women aged ≥65 years (Ptrend=0.032, 0.4% decrease/cycle).

Conclusion: There were missed opportunities for stroke prevention in this cohort, with sex and age differences observed in the use of primary prevention medications before first-ever stroke.