Department of Internal Medicine, Hospital de la Merced, Osuna, Seville, Spain.
Eur J Intern Med. 2009 Oct;20(6):586-90. doi: 10.1016/j.ejim.2009.06.005. Epub 2009 Jul 17.
Recurrent stroke is a major public health concern, occurring in approximately one third of stroke survivors within 5 years. Besides, the overall aging of the developed countries population and the improved survival of patients with stroke have created a large population of older adults in need of secondary stroke prevention. Thus, at present, more than 5% of individuals 65 to 74 years old and more than 10% of those 75 and older have had a prior stroke. An age bias exists in the prescription of important secondary-preventive therapies in the elderly. Knowledge of the evidence behind the secondary prevention strategies could be useful to practicing physicians caring for stroke elderly patients. Effective strategies for the secondary prevention of stroke include treatment of hypertension and hyperlipidaemia. Our review presents the most recent evidence on hypertension and lipid lowering therapy for stroke prevention in elderly patients with previous stroke or TIA. Basis for evidence (or the lack thereof), areas of controversy, and avenues of future focus for these treatments are also discussed in this paper.
复发性中风是一个主要的公共卫生问题，大约有三分之一的中风幸存者在 5 年内会再次中风。此外，由于发达国家人口的整体老龄化以及中风患者存活率的提高，需要进行二级中风预防的老年患者人群数量庞大。因此，目前，65 至 74 岁的人群中有超过 5%，75 岁及以上的人群中有超过 10%曾发生过中风。在为老年人开重要二级预防治疗药物时存在年龄偏见。了解二级预防策略背后的证据对照顾中风老年患者的执业医师可能有用。中风二级预防的有效策略包括治疗高血压和高血脂。我们的综述介绍了在有既往中风或 TIA 的老年患者中，预防中风的降压和降脂治疗的最新证据。本文还讨论了这些治疗方法的证据基础（或缺乏）、争议领域以及未来关注的方向。
