Stroke has become the 3rd leading cause of death among urban residents in China, and the combined rate ofrisk factorssuch as hypertension, diabetes, and dyslipidemia is high among urban high-risk groups. Liaoning Province is a high incidence area of stroke in China, however, there are a few studies on the recurrence of stroke and its combined risk factors in the northern urban areas.

To explore the recurrence status of surviving stroke patients aged over 40 and its combined risk factors in urban areas of Liaoning Province, in orderto provide a theoretical basis for formulating effective secondary prevention strategies.

From September 2018 to December 2020, 6 349 permanent urban residents aged over 40 in Liaoyang, Dandong, Benxi, and Chaoyang Cities of Liaoning Province were selected according to the economic and regional distribution using stratified cluster random samplingand investigated. A total of 488 surviving stroke patients were included and their recurrence rate and associated risk factors were analyzed in this study.

There were 244 males and 244 females among the 488 surviving stroke patients, the average age was (65.8±7.5) years old and the proportion of patients aged 60-69 was the largest (43.7%) ; There were 352 (72.1%) first-onset stroke patients, 136 (27.9%) recurrent stroke patients, and a recurrence rate of 27.9% among surviving stroke patients; The recurrence rates of male and female surviving stroke patients were 29.5% (72 cases) and 26.2% (64 cases) , respectively, and the difference was not statistically significant (χ²=0.652, P=0.419) . The recurrence rate of stroke among people aged 40-49, 50-59, 60-69, 70-79 and ≥80 years old was 4/11, 23.4% (22/94) , 25.4% (54/213) , 35.9% (47/131) and 23.1% (9/39) , respectively, there was no significant difference in recurrence rate between male and female surviving stroke patients in different age groups (P>0.05) .The current drinking rate of the relapsed patients was lower than that of the first-onset stroke patients, and the awareness rate of hypertension, dyslipidemia, the treatment rate of dyslipidemia, and the control rate of dyslipidemia were higher than those of the first-onset stroke patients, and the difference was statistically significant (P<0.05) .

The recurrence rate of surviving stroke patients aged over 40 in urban areas of Liaoning Province is high, and patients with recurrence have higher rates of smoking, physical inactivity, overweight or obesity, and poor control of combined risk factors such as hypertension and diabetes mellitus, which require comprehensive and effective secondary prevention measures to reduce the risk of recurrence, disability and death in stroke patients.

脑卒中已成为我国城市居民第3位死亡原因，城市脑卒中高危人群中高血压、糖尿病、脂代谢异常等危险因素合并率较高。辽宁省是我国脑卒中高发地区，目前对北方城市地区的脑卒中患者复发情况及其合并危险因素的研究较少。

了解辽宁省城市地区≥40岁存活脑卒中患者复发现状及其合并危险因素特征，为制定有效的二级预防策略提供理论依据。

2018年9月至2020年12月，根据经济和地区分布情况，采用随机、整群、分层的抽样方法，对辽宁省辽阳市、丹东市、本溪市和朝阳市的6 349例≥40岁常住居民进行调查，本研究共纳入其中488例存活脑卒中患者为研究对象。分析存活脑卒中患者复发率及其合并危险因素。

488例存活脑卒中患者中，男244例、女244例；平均年龄（65.8±7.5）岁，以60~69岁患者为主（43.7%）；初发脑卒中患者352例（72.1%），复发脑卒中患者136例（27.9%），存活脑卒中患者复发率为27.9%。男、女性存活脑卒中患者复发率分别为29.5%（72例）和26.2%（64例）。不同性别存活脑卒中患者复发率比较，差异无统计学意义（χ²=0.652，P=0.419）。40~49岁、50~59岁、60~69岁、70~79岁和≥80岁存活脑卒中患者复发率分别为4/11、23.4%（22/94）、25.4%（54/213）、35.9%（47/131）和23.1%（9/39），不同年龄段男、女性存活脑卒中患者复发率比较，差异无统计学意义（P>0.05）。脑卒中复发患者现饮酒率低于脑卒中初发患者，高血压知晓率、血脂异常知晓率、血脂异常治疗率和血脂异常控制率均高于脑卒中初发患者（P<0.05）。

辽宁省城市地区≥40岁存活脑卒中患者复发率较高，复发患者吸烟、缺乏运动及超重或肥胖率较高，合并高血压、糖尿病等危险因素且控制不佳，亟待针对性开展综合有效的二级预防措施以降低脑卒中患者再次复发、残障和死亡风险。