MODIFIABLE RISK FACTORS IN SECONDARY PREVENTION OF MYOCARDIAL INFARCTION AND ISCHEMIC STROKE IN ATHEROSCLEROSIS: A SYSTEMATIC REVIEW

Abstract

Cardiovascular diseases impose a substantial burden on global health, remaining a leading cause of morbidity and premature death. This systematic review aimed to describe and compare the reported prevalence of key cardiovascular risk factors in secondary prevention of myocardial infarction and ischemic stroke. The literature search identified 2831 published studies. After removing duplicates, screening the titles and abstracts, and evaluating the potentially eligible studies, 49 epidemiological studies were included, assessing the prevalence of them. Pearson’s correlation coefficient was applied to assess the relationships among the main risk factors. Dyslipidemia and hypertension were found to be the most prominent risk factors for myocardial infarction, each with an average prevalence of 50.5%, with a moderate to strong positive correlation between their prevalences (r = 0.61, p = 0.007). For ischemic stroke, dyslipidemia had a prevalence of 44.9%, while hypertension was higher at 66.8%. Smoking and diabetes mellitus were also significant, with average prevalences of 42.9% and 33.3% for myocardial infarction, and 33.6% and 29.8% for stroke, respectively. Our findings emphasize the frequent reporting of major modifiable risk factors, reinforcing the importance of comprehensive management strategies in secondary prevention. Dyslipidemia was consistently documented across studies involving both myocardial infarction and ischemic stroke. These results also align with existing global evidence, supporting the role of lipid-lowering therapies and integrated prevention strategies in reducing the burden of cardiovascular disease.