Effect and efficacy of lifestyle interventions as secondary prevention

Jacob Liljehult, Thomas Christensen, Stig Molsted, Dorthe Overgaard, Monique Mesot Liljehult, Tom Moller

Research output: Contribution to journalReview articlepeer-review


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 and 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.
Original languageEnglish
JournalActa Neurologica Scandinavica
Issue number4
Pages (from-to)299-313
Number of pages15
Publication statusPublished - 1 Oct 2020


  • adherence
  • exercise
  • health behaviour
  • health counselling
  • physical activity
  • smoking
  • stroke
  • transient ischaemic attack


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