Journal of Neurology

, Volume 266, Issue 5, pp 1194–1202 | Cite as

Lifestyles correlate with stroke recurrence in Chinese inpatients with first-ever acute ischemic stroke

  • Zhi-Xin HuangEmail author
  • Xiao-Ling Lin
  • Hai-Ke Lu
  • Xiao-Yu Liang
  • Li-Juan Fan
  • Xin-Tong Liu
Original Communication



The previous studies have shown that recurrent stroke (RS) adversely affects the life of survivors of ischemic stroke (IS). However, lifestyle associated with RS has received a little systematic study in Chinese Han patients. We aimed to perform a comprehensive assessment of lifestyle and the potential risk factors associated with RS in Chinese Han inpatients with first-ever acute ischemic stroke by conducting a long-term follow-up.


Using a prospective and longitudinal design, we recruited 421 patients with first-ever acute ischemic stroke who were consecutively admitted to the Acute Stroke Unit between November 2012 and January 2014. Demographic data, vascular risk factors, previous Rankin scale score, and etiology were collected at study intake. Multivariable Cox regression model was used to investigate the influencing factors for RS.


Fifty-seven (13.5%) patients experienced RS during the 1-year follow-up period. Multivariable Cox regression analysis revealed that smoking [hazard ratio (HR), 2.153; 95% confidence interval (CI), 1.263–3.671], high-density lipoprotein cholesterol (HDL) (HR 0.438; 95% CI 0.211–0.911), housework (HR 0.488; 95% CI 0.256–0.933), ischemic heart disease (IHD) (HR 2.998; 95% CI 1.281–7.020), daily consumption of fresh fruits (HR 0.477; 95% CI 0.278–0.819), and good sleep quality (HR 0.375; 95% CI 0.216–0.650) were associated with RS among stroke patients.


Our results suggest that healthy lifestyle (high fruit intake, smoking cessation, housework, and good sleep quality), higher HDL levels, and lack of IHD may be associated with a lower risk of RS in patients with first-onset IS.


Cerebral infarction Lifestyle Recurrent stroke Risk factors Stroke 



This work was partially supported by the Science and Technology Program of Guangzhou, China (201707010436), Guangdong Second Provincial General Hospital Medical Scientific Research Projects (YY2016-005), and Administration of Traditional Chinese Medicine of Guangdong Province, China (20173024; 20181012). We want to thank Xiang Yang Zhang of the University of Texas Health Science Center at Houston for her advice on Methods and Results sections.

Compliance with ethical standards

Conflicts of interest

The author declares that there is no competing interest.

Ethical standards

The study protocol was approved by the Ethical Committee of the Guangdong Second Provincial General Hospital, and conformed to the ethical guidelines of the 1975 Declaration of Helsinki, with all participants in this study providing written informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Zhi-Xin Huang
    • 1
    • 2
    • 3
    Email author
  • Xiao-Ling Lin
    • 4
  • Hai-Ke Lu
    • 1
    • 2
    • 3
  • Xiao-Yu Liang
    • 1
    • 2
    • 3
  • Li-Juan Fan
    • 5
  • Xin-Tong Liu
    • 1
    • 2
    • 3
  1. 1.Department of NeurologyGuangdong Second Provincial General HospitalGuangzhouChina
  2. 2.Center for Cerebrovascular DiseasesGuangdong Second Provincial General HospitalGuangzhouChina
  3. 3.Department of Neurology, Affiliated Nanyue HospitalSouthern Medical UniversityGuangzhouChina
  4. 4.School of NursingSun Yat-sen UniversityGuangzhouChina
  5. 5.Department of NeurologyBeijing Armed Police Corps HospitalBeijingChina

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