Nussbaumerová Barbora
Vnitr Lek. 2022 Fall;68(3):172-177.
Stroke is the second most common cause of mortality worldwide and the third most common cause of disability. Arterial hypertension is the most prevalent risk factor for stroke. A precise management of arterial hypertension prevents the first episode of stroke and the recurrence. Blood pressure must be decreased carefully and not very vigorously in the acute phase of the stroke. Recommended blood pressure goals in chronic tratment are at least 140 / 90 mm Hg and lower if tolerated. ACE inhibitors or angiotensin receptor blockers in combination with calcium channel blockers or indapamide are favorable antihypertensive drugs. Dyslipidemia is also a strong risk factor for ischaemic stroke and has no relatioship to the other etiologies of stroke. The cardiovascular risk in patients after a stroke is very high. An intensive hypolipidemic treatment by statins, ezetimibe and PCSK9i to LDL-cholesterol goals < 1,4 mmol/l and a 50% decrease was proved to decrease the incidence of recurrent stroke.
中风是全球第二大常见死因，也是第三大常见致残原因。动脉高血压是中风最普遍的危险因素。对动脉高血压进行精确管理可预防首次中风发作及复发。在中风急性期，血压必须谨慎降低，而非大幅降低。慢性治疗中推荐的血压目标至少为140/90毫米汞柱，若能耐受则更低。血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂与钙通道阻滞剂或吲达帕胺联合使用是理想的降压药物。血脂异常也是缺血性中风的一个重要危险因素，与中风的其他病因无关。中风后患者的心血管风险非常高。事实证明，通过他汀类药物、依折麦布和前蛋白转化酶枯草溶菌素9抑制剂进行强化降脂治疗，使低密度脂蛋白胆固醇目标值低于1.4毫摩尔/升且降低50%，可降低复发性中风的发生率。
