Effect and efficacy of lifestyle interventions as secondary prevention

Acta Neurol Scand. 2020 Oct;142(4):299-313. doi: 10.1111/ane.13308. Epub 2020 Jul 15.

Abstract

Introduction: Improvements in health behaviour are often recommended as part of secondary prevention in patients with stroke and transient ischaemic attack. However, there is a lack of knowledge as to how this is applied in clinical practice.

Aim: In this systematic review and meta-analysis, we examined the effect of counselling or educational intervention directed at individual or multiple behavioural risk factors on blood pressure and other reported outcomes.

Methods: PubMed, Embase, PsycInfo, CINAHL, Scopus and Web of Science were systematically searched. Meta-analyses were conducted on all outcome measures if appropriate. A qualitative analysis of the content of the interventions was conducted to review which elements the interventions consisted of.

Results: Twenty-nine randomized controlled trials were identified. Fourteen reported effects on systolic blood pressure, and pooled results showed a significant beneficial effect (n = 2,222; -3.85 mmHg [95%CI -6.43; -1.28]). The effect was greatest in the four interventions which included supervised training (n = 174; -9.83 mmHg [95%CI -16.56; -3.09]).

Conclusion: Modifying health behaviour in stroke survivors might have a moderate beneficial effect on blood pressure, especially if the intervention includes supervised physical training.

Keywords: adherence; exercise; health behaviour; health counselling; physical activity; smoking; stroke; transient ischaemic attack.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blood Pressure
  • Humans
  • Ischemic Attack, Transient / prevention & control*
  • Life Style*
  • Risk Factors
  • Secondary Prevention / methods*
  • Stroke / prevention & control*
  • Survivors / psychology*