Ischemic stroke primary prevention
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Primary prevention of ischemic stroke is mainly aimed at treatment and modifcation of risk factors which are directly associated with increased occurrence of ischemic stroke.
Up to 90% of all strokes are preventable, and attributable to 10 modifiable risk factors. Case-control studies showed that 10 vascular risk factors and concomitant diseases account for 90% of the stroke risk including history of hypertension or blood pressure ≥140/90 mm Hg, lack of regular physical activity, apolipoprotein B/A1 ratio, diet (mAHEI score), Waist-to-hip ratio, Psychosocial factors, current smoking, cardiac causes (AF, MI, RhVD, PVD), alcohol intake, and history of diabetes mellitus or HbA1c ≥6.5. Lifestyle modifications including healthy diet, weight loss, termination of smoking, and regular physical activity are recommended as primary prevention for stroke events. Reducing blood pressure in persons with hypertension is highly effective in preventing ischemic stroke; every 10-mm Hg reduction in systolic blood pressure and 5-mm Hg reduction in diastolic blood pressure reduces the risk of stroke by 41%.
Primary prevention of ischemic stroke is mainly aimed at treatment and modifcation of risk factors which are directly associated with increased occurrence of ischemic stroke. Effective measures for primary prevention of stroke include:
- Genetic testing and treatment for diseases with increased risk of ischemic stroke such as Fabry's disease
- Life style modifications such as increased physical activity in obese or over weight patients to maintain healthy weight
- Treatment of hypertension, diabetes mellitus and hyperlipidemia
- Treatment of atrial fibrillation and anticoagulant prophylaxis
- Procedures such as carotid endarterectomy or carotid angioplasty can be used to remove significant atherosclerotic narrowing (stenosis) of the carotid artery
- Smoking cessation and decreased alcohal intake
For AHA/ASA guidelines for primary prevention of stroke, click here.
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