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Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association.

Authors
  • Gorelick, P B
  • Sacco, R L
  • Smith, D B
  • Alberts, M
  • Mustone-Alexander, L
  • Rader, D
  • Ross, J L
  • Raps, E
  • Ozer, M N
  • Brass, L M
  • Malone, M E
  • Goldberg, S
  • Booss, J
  • Hanley, D F
  • Toole, J F
  • Greengold, N L
  • Rhew, D C
Type
Published Article
Journal
JAMA
Publication Date
Jan 01, 1999
Volume
281
Issue
12
Pages
1112–1120
Identifiers
PMID: 10188663
Source
Medline
License
Unknown

Abstract

Several interventions that modify well-documented and treatable cardiovascular and cerebrovascular risk factors can reduce the risk of a first stroke. Good evidence for direct stroke reduction exists for hypertension treatment; using warfarin for patients after MI who have atrial fibrillation, decreased left ventricular ejection fraction, or left ventricular thrombus; using 3-hydroxy-3 methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors for patients after MI; using warfarin for patients with atrial fibrillation and specific risk factors; and performing carotid endarterectomy for patients with stenosis of at least 60%. Observational studies support the role of modifying lifestyle-related risk factors (eg, smoking, alcohol use, physical activity, diet) in stroke prevention. Measures to help patients improve adherence are an important component of a stroke prevention plan.

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