Prevention of ischaemic stroke

摘要

Reduction of blood pressure is effective at preventing a first stroke, but it is not clear which patients with stroke should be treated with antihypertensives (and at what blood pressure), what the best drug regimen is, or when treatment should start. Risky or expensive medical interventions for stroke prevention should be targeted at those at high risk because the absolute benefits are greatest in such patients. Lowering cholesterol concentration with drugs may reduce the risk of non-fatal stroke, but the effects on the risk of fatal stroke and haemorrhagic stroke are unclear. The balance of risk and benefits of endarterectomy in most patients with a stenosis without symptoms is unclear. A diet rich in fresh fruit and vegetables and low in salt and fat, regular exercise, and the avoidance of smoking may reduce the lifetime risk of first stroke, but the effects on secondary prevention of stroke are unclear.