scholarly journals Is Blood Pressure Control for Stroke Prevention the Correct Goal?

Stroke ◽  
2015 ◽  
Vol 46 (6) ◽  
pp. 1595-1600 ◽  
Author(s):  
George Howard ◽  
Maciej Banach ◽  
Mary Cushman ◽  
David C. Goff ◽  
Virginia J. Howard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Stroke Prevention ◽  
Pressure Control

Stroke prevention 2003: are we any closer to adequate blood pressure control?

2003 ◽  
Vol 12 (5) ◽  
pp. 248
Author(s):  
W. Fedder ◽  
A. Golembiewski ◽  
M. Conti ◽  
D. Book ◽  
M. Torbey
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Stroke Prevention ◽  
Pressure Control

scholarly journals Advances in Stroke Prevention

2018 ◽  
Vol 6 (3) ◽  
pp. 105-114 ◽  
Author(s):  
J. David Spence
Keyword(s):  
Blood Pressure ◽  
Carotid Stenosis ◽  
Blood Pressure Control ◽  
Stroke Prevention ◽  
Patent Foramen Ovale ◽  
Pressure Control ◽  
B Vitamins ◽  
Foramen Ovale ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid

Abstract There have been recent advances in stroke prevention in nutrition, blood pressure control, antiplatelet therapy, anticoagulation, identification of high-risk asymptomatic carotid stenosis, and percutaneous closure of patent foramen ovale. There is evidence that the Mediterranean diet significantly reduces the risk of stroke and that B vitamins lower homocysteine, thus preventing stroke. The benefit of B vitamins to lower homocysteine was masked by harm from cyanocobalamin among study participants with impaired renal function; we should be using methylcobalamin instead of cyanocobalamin. Blood pressure control can be markedly improved by individualized therapy based on phenotyping by plasma renin and aldosterone. Loss of function mutations of CYP2D19 impair activation of clopidogrel and limits its efficacy; ticagrelor can avoid this problem. New oral anticoagulants that are not significantly more likely than aspirin to cause severe bleeding, and prolonged monitoring for atrial fibrillation (AF), have revolutionized the prevention of cardioembolic stroke. Most patients (~90%) with asymptomatic carotid stenosis are better treated with intensive medical therapy; the few that could benefit from stenting or endarterectomy can be identified by a number of approaches, the best validated of which is transcranial Doppler (TCD) embolus detection. Percutaneous closure of patent foramen ovale has been shown to be efficacious but should only be implemented in selected patients; they can be identified by clinical clues to paradoxical embolism and by TCD estimation of shunt grade. “Treating arteries instead of treating risk factors,” and recent findings related to the intestinal microbiome and atherosclerosis point the way to promising advances in future.

scholarly journals Relative and Cumulative Effects of Lipid and Blood Pressure Control in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels Trial

Stroke ◽  
2009 ◽  
Vol 40 (7) ◽  
pp. 2486-2492 ◽  
Author(s):  
Pierre Amarenco ◽  
Larry B. Goldstein ◽  
Michael Messig ◽  
Blair J. O'Neill ◽  
Alfred Callahan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Stroke Prevention ◽  
Pressure Control ◽  
Cumulative Effects ◽  
Cholesterol Levels
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