Missed opportunities for secondary prevention of cerebrovascular disease in elderly British men from 1999 to 2005: a population-based study

J Public Health (Oxf). 2007 Sep;29(3):251-7. doi: 10.1093/pubmed/fdm040. Epub 2007 Jun 21.


Objective: We examined patterns in medication use for secondary prevention of cerebrovascular disease in older British men from 1999 to 2005, and investigated socio-demographic and disease-related influences on medication use.

Methods: Percentage use of antiplatelet drugs, blood pressure-lowering drugs and statins use was calculated in men, aged 65-87 years in 2005, who had been diagnosed with stroke or transient ischaemic attack (TIA) from a population-based cohort based in one general practice in each of 24 British towns.

Results: In 1999, most men with cerebrovascular disease received antiplatelet drugs (67%). However, a few received blood pressure-lowering drugs (50%) and statins (13%). By 2005, the use of all drug types had increased; at least half of the patients received each type of drug. However, only one-third of patients received all three medication types and combined blood pressure treatment was limited. Older age, a diagnosis of TIA rather than stroke and absence of co-existing coronary heart disease were associated with lower rates of use of specific medication categories.

Conclusion: Despite improvements in secondary prevention medication use, there is scope for achieving the full potential of these medications, particularly by increasing combination blood pressure treatment and statin use and ensuring that older patients receive the benefits of prevention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / drug therapy
  • Cerebrovascular Disorders / prevention & control*
  • Drug Utilization / statistics & numerical data*
  • Family Practice / standards*
  • Health Care Surveys
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Ischemic Attack, Transient / drug therapy*
  • Ischemic Attack, Transient / physiopathology
  • Male
  • Platelet Aggregation Inhibitors / therapeutic use
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prospective Studies
  • Risk Factors
  • Secondary Prevention
  • Stroke / drug therapy*
  • Stroke / physiopathology
  • Surveys and Questionnaires
  • Time Factors
  • United Kingdom


  • Antihypertensive Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors