Berlit P
Neurologische Klinik, Alfried Krupp Krankenhaus, Essen.
Nervenarzt. 2000 Apr;71(4):231-6. doi: 10.1007/s001150050552.
Age, gender, race, and genetic factors count among the nonmodifiable risk factors for stroke. But primary prevention is possible through modification of other vascular risk factors. The treatment of arterial hypertension, with optimal values around 135/85 mmHg, reduces the risk of stroke by 50%. A significant risk reduction for ischemic stroke is possible with at least 30 minutes of physical activity twice a week, cessation of cigarette smoking, and treatment of hypercholesterolemia with statins. Dietary measures should include a reduction of animal proteins, normalization of body weight and a large amount of fruit and vegetables; small amounts of wine are allowed. A hyperhomocystinemia is treated with folic acid. Low dose estrogens (< 50 micrograms) do not increase the risk of ischemic stroke in young females, but are capable of reducing hypercholesterolemia in postmenopausal women if triglycerides are normal. Neither primary prevention of stroke with antiagreggants nor surgery for asymptomatic carotid artery stenoses is recommended as preventive treatment, but low dose anticoagulation is the prophylaxis of choice for atrial fibrillation.
年龄、性别、种族和遗传因素属于中风的不可改变的风险因素。但通过改变其他血管风险因素可以进行一级预防。将动脉高血压控制在约135/85 mmHg的最佳值，可使中风风险降低50%。每周至少进行两次30分钟的体育活动、戒烟以及用他汀类药物治疗高胆固醇血症，可显著降低缺血性中风的风险。饮食措施应包括减少动物蛋白摄入、使体重正常化以及大量食用水果和蔬菜；允许少量饮酒。高同型半胱氨酸血症用叶酸治疗。低剂量雌激素（<50微克）不会增加年轻女性缺血性中风的风险，但如果甘油三酯正常，能够降低绝经后女性的高胆固醇血症。不推荐使用抗血小板药物进行中风的一级预防，也不建议对无症状颈动脉狭窄进行手术作为预防性治疗，但低剂量抗凝是心房颤动的首选预防措施。
