Department of Neurology, Yale University, 15 York Street, New Haven, CT, 06510, USA.
Neurotherapeutics. 2023 Apr;20(3):721-731. doi: 10.1007/s13311-023-01352-w. Epub 2023 Mar 6.
The health burden of ischemic stroke is high and will continue to increase with an aging population. Recurrent ischemic stroke is increasingly recognized as a major public health concern with potentially debilitating sequelae. Thus, it is imperative to develop and implement effective strategies for stroke prevention. When considering secondary ischemic stroke prevention, it is important to consider the mechanism of the first stroke and the related vascular risk factors. Secondary ischemic stroke prevention typically includes multiple medical and, potentially, surgical treatments, but with the shared goal of reducing the risk of recurrent ischemic stroke. Providers, health care systems, and insurers also need to consider the availability of treatments, their cost and patient burden, methods for improving adherence, and interventions that target lifestyle risk factors such as diet or activity. In this article, we discuss aspects from the 2021 AHA Guideline on Secondary Stroke Prevention as well as highlight additional information relevant to best practices for reducing recurrent stroke risk.
缺血性脑卒中的健康负担很高,并且随着人口老龄化,这种负担还将继续增加。复发性缺血性脑卒中越来越被认为是一个主要的公共卫生问题,可能会导致致残的后果。因此,制定和实施有效的脑卒中预防策略至关重要。在考虑二级预防缺血性脑卒中时,需要考虑首次脑卒中的机制和相关的血管危险因素。二级预防通常包括多种医疗措施,并且可能还需要手术治疗,但共同的目标是降低复发性缺血性脑卒中的风险。提供者、医疗保健系统和保险公司还需要考虑治疗方法的可及性、成本和患者负担、提高患者依从性的方法,以及针对饮食或活动等生活方式危险因素的干预措施。在本文中,我们讨论了 2021 年 AHA 二级预防指南中的相关内容,并强调了与降低复发性脑卒中风险的最佳实践相关的其他信息。