Health-related quality of life after first-ever acute ischemic stroke: associations with cardiovascular health metrics

• Published in: Quality of life research Vol. 30; no. 10; pp. 2907 - 2917
• Main Authors: She, Rui, Yan, Zhongrui, Hao, Yanlei, Zhang, Zuoji, Du, Yifeng, Liang, Yajun, Vetrano, Davide L., Dekker, Joost, Bai, Bo, Lau, Joseph T. F., Qiu, Chengxuan
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2021; Springer Nature B.V
• Subjects: Adult; Blood pressure; Brain Ischemia - epidemiology; Cardiovascular disease risks; Cardiovascular Diseases - epidemiology; Cognitive ability; Cognitive impairment; Exercise; Female; Function; Health Status; Humans; Ischemia; Ischemic Stroke; Male; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Public Health; Quality Indicators, Health Care; Quality of life; Quality of Life - psychology; Quality of Life Research; Risk Factors; Sociology; Stroke; Stroke - epidemiology; China; Function; Stroke; Cardiovascular disease risks; Quality of life; Cognitive impairment
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-021-02853-x

Purpose To investigate the associations between cardiovascular health (CVH) metrics and health-related quality of life (HRQL) among patients with ischemic stroke in China, and further explore the role of physical and cognitive function in their associations. Methods This hospital-based study included 1714 patients with first-ever acute ischemic stroke (age ≥ 40 years; 36.7% women) who were admitted to two university hospitals in Shandong, China. We collected information on seven CVH metrics (smoking, body mass index, diet, physical activity, blood pressure, total cholesterol, and fasting blood glucose) through interviews, clinical examinations, and laboratory tests. EQ-5D-3L was used to assess HRQL. Cognitive and physical functioning was assessed by the Montreal Cognitive Assessment test and Barthel index, respectively. Data were analyzed using the general linear regression models. Results The average score (SD) was 0.746 (0.23) for HRQL index and 72.7 (15.8) for self-rated health. Optimal levels of four individual CVH metric components (diet, physical activity, blood pressure, and blood glucose) and a higher composite CVH score were significantly associated with a greater HRQL index and better self-rated health ( p  < 0.05 for all). Physical dependence and cognitive impairment were associated with a lower HRQL index and poorer self-rated health status ( p  < 0.001). Furthermore, the relationships between CVH metrics and HRQL index varied by functional status, such that their associations were statistically significant only among people who had physical dependence or cognitive impairment. Conclusion Achieving a better cardiovascular health profile is associated with better quality of life among ischemic stroke survivors, primarily in those with physical or cognitive impairment.