Spence J David
Stroke Prevention & Atherosclerosis Research Centre, London, ON, Canada.
Curr Neurol Neurosci Rep. 2007 Jan;7(1):42-8. doi: 10.1007/s11910-007-0020-8.
Patients at high risk of vascular events can reduce their risk by 75% to 80% through a combination of lifestyle changes and medical therapy. These include smoking cessation, a Mediterranean diet, daily exercise, maintaining a fit weight, moderate consumption of alcohol, effective control of blood pressure and diabetes, intensive treatment with lipid-lowering drugs and antiplatelet agents, and perhaps treatment with vitamins to lower homocysteine. Much of this is achieved primarily by the patient; physicians need to become better at assisting their patients in making lifestyle changes. Effective control of treatment-resistant hypertension can be improved by individualizing medical therapy to the underlying cause, based on measurement of plasma renin and aldosterone. Measurement of carotid plaque may be useful by providing feedback on the success of therapy.
血管事件高危患者可通过改变生活方式和药物治疗相结合的方式将风险降低75%至80%。这些措施包括戒烟、地中海饮食、每日锻炼、保持合适体重、适度饮酒、有效控制血压和糖尿病、强化使用降脂药物和抗血小板药物治疗，或许还可使用维生素来降低同型半胱氨酸水平。其中大部分主要靠患者自身来实现；医生需要更善于协助患者改变生活方式。根据血浆肾素和醛固酮的测量结果，针对潜在病因进行个体化药物治疗，可改善对难治性高血压的有效控制。通过提供治疗效果的反馈，颈动脉斑块测量可能会有所帮助。
