Introduction: Recurrent stroke contributes to the global stroke burden, particularly in low- and middle-income countries like Brazil. Consequently, secondary stroke prevention, centered on adopting healthy lifestyle behaviors, is a priority solution to reduce the global burden of strokes. While predictors of the adoption of healthy behaviors post-stroke have been studied in high-income countries, identifying these predictors in middle-income countries can help target individuals for secondary prevention and develop focused interventions. This study aims to investigate whether sociodemographic and clinical risk factors for recurrent stroke predict the adoption of healthy lifestyle behaviors post-stroke in a middle-income country.
Methods: This is a cross-sectional study that included individuals post-stroke from a Brazilian metropolis using the Stroke RiskometerTM App, from September 2021 to February 2023. Binary logistic regression models (α=5%) were employed. The dependent variables were as follows: four separate healthy lifestyle behaviors and their simultaneous adoption. The independent variables were as follows: age, sex, cardiac conditions, hypertension, diabetes, body mass index, and emotional stress or depression.
Results: In total, 81 individuals (63±14 years) were included in the study; they had the following characteristics: 22% spent ≥2.5 hours in physical activity/week, 68% consumed ≥2 servings of fruits and/or vegetables/day, 88% were non-smokers, 95% reported safe alcohol consumption, and 16% adopted all four healthy behaviors. Individuals who did not experience emotional stress or depression were more likely to not smoke (B=1.896, p=0.04) and older individuals were less likely to adopt all four healthy behaviors (B=-0.072, p=0.02).
Conclusions: Emotional stress or depression and age were predictors of adopting healthy behaviors post-stroke in a middle-income country. These variables should be targeted in prioritizing individuals for secondary stroke prevention and in developing interventions.
