Prabhakaran Shyam, Chong Ji Y
Continuum (Minneap Minn). 2014 Apr;20(2 Cerebrovascular Disease):296-308. doi: 10.1212/01.CON.0000446102.82420.64.
This review focuses on the recommendations for management of hypertension, dyslipidemia, diabetes mellitus, diet, physical activity, and lifestyle choices commonly encountered in neurologic practice. Specific studies, including those relevant to lipid targets, blood pressure targets, and adherence to medications after stroke, are reviewed.
In addition to traditional risk factors such as hypertension, dyslipidemia, and diabetes mellitus, this review discusses sleep apnea, diet, physical activity, and other novel risk factors that are potentially modifiable. Recent studies confirm that pharmacologic strategies to achieve aggressive targets for lipid and blood pressure lowering have significant impact on recurrent stroke risk.
Optimal secondary prevention strategies can prevent as much as 80% of all recurrent strokes.
本综述重点关注神经病学实践中常见的高血压、血脂异常、糖尿病、饮食、体育活动及生活方式选择的管理建议。对包括与血脂目标、血压目标及卒中后药物依从性相关的特定研究进行了综述。
除高血压、血脂异常和糖尿病等传统危险因素外,本综述还讨论了睡眠呼吸暂停、饮食、体育活动及其他可能可改变的新型危险因素。近期研究证实,实现积极的血脂和血压降低目标的药物治疗策略对复发性卒中风险有显著影响。
最佳二级预防策略可预防高达80%的所有复发性卒中。