# Poor Sleep, Sedentary Behavior, and Secondary Cardiovascular Risk in Stroke and TIA Patients.

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2021 · $669,800

## Abstract

The goal of this ancillary R01 is to evaluate sleep and sedentary behavior after stroke or transient ischemic
attack (TIA) as potential therapeutic targets to reduce risk of secondary cardiovascular disease (CVD). We will
also identify modifiable predictors of poor sleep and sedentary behavior post-stroke/TIA to guide early
intervention efforts. Stroke is the leading cause of serious long-term disability in the U.S., with nearly 1 million
inpatient admissions per year (~1 person every 40 sec). New technologies and medications for acute
stroke/TIA ensure that most patients survive, but within 1 year, 1 in 4 survivors will die or have a recurrent
CVD event. Identification of novel secondary prevention targets is thus vitally important. Evidence from large
observational cohort studies and laboratory-based mechanistic experiments have indicated a link between both
poor sleep duration (short or long) and sedentary behavior with increased risk for incident and recurrent CVD
morbidity and mortality. Stroke survivors are particularly likely to experience poor sleep duration and high
volumes of sedentariness after hospitalization. No existing guidelines for secondary prevention mention sleep
or sedentary behavior as risk factors to target in stroke survivors. To influence guidelines, research must
determine whether objectively-measured sleep duration and sedentary behavior are associated with increased
morbidity/mortality risk post-stroke. It is also important to understand whether, and how, these emerging risk
factors may interact to increase post-stroke recurrence and mortality risk. We will therefore conduct a
comprehensive and objective assessment of the overall 24-h behavioral activity profile to investigate the
independent and joint contributions of poor sleep and sedentary behavior to stroke recurrence/mortality. The
current parent study is a longitudinal cohort study of stroke/TIA patients who present to the emergency room
and are followed for 1 year to determine (1) predictors of stroke-induced post-traumatic stress disorder (PTSD)
and (2) whether stroke-induced PTSD is a risk factor for recurrent CVD events and mortality. In this ancillary
project we propose to use triaxial wrist-accelerometers to measure sleep and sedentary behavior objectively for
45 days post-discharge in 1,016 patients enrolled in the parent study. We will also survey patients at enrollment
and 1-month follow-up to identify predictors of poor sleep and sedentary behavior post-discharge. These
findings will be used to primarily evaluate whether objectively-measured sleep duration and sedentary
behavior are associated with risk of 1-year recurrent events/mortality in stroke/TIA survivors. If these
behaviors explain a substantial portion of excess risk for recurrent cardiovascular events and mortality, we will
have a foundation to target these behaviors for secondary risk reduction in this patient population. Findings
will inform novel interventions to improve sleep and reduce ...

## Key facts

- **NIH application ID:** 10146459
- **Project number:** 5R01HL141494-04
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Ari Shechter
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $669,800
- **Award type:** 5
- **Project period:** 2018-05-04 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10146459

## Citation

> US National Institutes of Health, RePORTER application 10146459, Poor Sleep, Sedentary Behavior, and Secondary Cardiovascular Risk in Stroke and TIA Patients. (5R01HL141494-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10146459. Licensed CC0.

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