Recent advances in preventing stroke recurrence [version 1; referees: 2 approved]
Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with pl...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
F1000 Research Ltd
2017-06-01
|
| Series: | F1000Research |
| Subjects: | |
| Online Access: | https://f1000research.com/articles/6-1017/v1 |
| _version_ | 1818943312388685824 |
|---|---|
| author | J David Spence |
| author_facet | J David Spence |
| author_sort | J David Spence |
| collection | DOAJ |
| description | Recent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%. There are problems with clopidogrel that can be overcome by using ticagrelor, and new anticoagulant drugs markedly improve anticoagulation for stroke prevention, particularly in atrial fibrillation. There are pharmacokinetic problems with dabigatran that deserve attention. Intensive medical therapy is better than stenting for intracranial stenosis, and new therapies directed at proprotein convertase subtilisin–kexin type 9 (PCSK9) will revolutionize lipid-lowering therapy. In the past, it was estimated that rational therapy could reduce recurrent stroke by about 80%. With recent advances, we should be able to do even better. |
| first_indexed | 2024-12-20T07:25:20Z |
| format | Article |
| id | doaj.art-58597416bfd44bfca1785d58a2362546 |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-12-20T07:25:20Z |
| publishDate | 2017-06-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-58597416bfd44bfca1785d58a23625462022-12-21T19:48:33ZengF1000 Research LtdF1000Research2046-14022017-06-01610.12688/f1000research.11597.112527Recent advances in preventing stroke recurrence [version 1; referees: 2 approved]J David Spence0Robarts Research Institute, Western University, London, ON, CanadaRecent advances in secondary stroke prevention include new evidence in hypertension, nutrition, anticoagulation, antiplatelet therapy, intracranial stenosis, percutaneous closure of patent foramen ovale, and lipid-lowering therapy. Individualized therapy for hypertension based on phenotyping with plasma renin and aldosterone markedly improves blood pressure control in patients with resistant hypertension. A Mediterranean diet can reduce the risk of stroke by nearly half. The diagnosis and treatment of metabolic vitamin B12 deficiency, and B vitamins to lower homocysteine, can reduce the risk of stroke by approximately 30%. There are problems with clopidogrel that can be overcome by using ticagrelor, and new anticoagulant drugs markedly improve anticoagulation for stroke prevention, particularly in atrial fibrillation. There are pharmacokinetic problems with dabigatran that deserve attention. Intensive medical therapy is better than stenting for intracranial stenosis, and new therapies directed at proprotein convertase subtilisin–kexin type 9 (PCSK9) will revolutionize lipid-lowering therapy. In the past, it was estimated that rational therapy could reduce recurrent stroke by about 80%. With recent advances, we should be able to do even better.https://f1000research.com/articles/6-1017/v1Arrhythmias, Electrophysiology & PacingBleeding & Coagulation DisordersCardiovascular PharmacologyCerebrovascular DiseaseCongenital Heart DiseaseCoronary Artery DiseaseEpidemiologyGlobal HealthHypertensionVascular Diseases (Non-Coronary) |
| spellingShingle | J David Spence Recent advances in preventing stroke recurrence [version 1; referees: 2 approved] F1000Research Arrhythmias, Electrophysiology & Pacing Bleeding & Coagulation Disorders Cardiovascular Pharmacology Cerebrovascular Disease Congenital Heart Disease Coronary Artery Disease Epidemiology Global Health Hypertension Vascular Diseases (Non-Coronary) |
| title | Recent advances in preventing stroke recurrence [version 1; referees: 2 approved] |
| title_full | Recent advances in preventing stroke recurrence [version 1; referees: 2 approved] |
| title_fullStr | Recent advances in preventing stroke recurrence [version 1; referees: 2 approved] |
| title_full_unstemmed | Recent advances in preventing stroke recurrence [version 1; referees: 2 approved] |
| title_short | Recent advances in preventing stroke recurrence [version 1; referees: 2 approved] |
| title_sort | recent advances in preventing stroke recurrence version 1 referees 2 approved |
| topic | Arrhythmias, Electrophysiology & Pacing Bleeding & Coagulation Disorders Cardiovascular Pharmacology Cerebrovascular Disease Congenital Heart Disease Coronary Artery Disease Epidemiology Global Health Hypertension Vascular Diseases (Non-Coronary) |
| url | https://f1000research.com/articles/6-1017/v1 |
| work_keys_str_mv | AT jdavidspence recentadvancesinpreventingstrokerecurrenceversion1referees2approved |