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.
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.
PubMed, Embase, PsycInfo, CINAHL, Scopus & 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.
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]).
Modifying health behaviour in stroke survivors might have a moderate beneficial effect on blood pressure, especially if the intervention includes supervised physical training.

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