Stroke Prevention

by Norris, John W.; Hachinski, Vladimir

• ISBN13: 9780195133820
• ISBN10: 019513382X
• Format: Hardcover
• Copyright: 2001-04-12
• Publisher: Oxford University Press

Summary

The treatment of stroke remains ineffective, and prevention is the key issue for this common disease. Norris and Hachinski have recruited an international group of experts to provide a comprehensive, critical review of the evidence on the primary and secondary prevention of cerebrovascular disease and to translate this information into clinical practice. The authors present fresh information on established risk factors such as atrial fibrillation, smoking and hypertension and on new risk factors such as homocysteinemia and the paradoxical role of alcohol. They cover the protective effects of lifestyle changes, diet, exercise, and estrogen. Under secondary prevention, they deal with aspirin, antiplatelet therapy, surgical measures to prevent stroke, angioplasty and stenting, and the importance of cardiac anomalies increasingly revealed by high-definition imaging. While endarterectomy remains controversial for asymptomatic carotid stenosis, it has been clearly defined as the single most effective strategy in secondary prevention. In a concluding section that will be particularly valuable to clinical readers, the authors provide a lucid, balanced discussion of how the findings from clinical trials, where patients are highly selected, closely monitored, and given the highest standard of care, can be effectively applied in the everyday practice of medicine.

Table of Contents

Contributors	ix
Prevention of Stroke: A Perspective	1	(16)
John W. Norris
Vladimir Hachinski
I Primary Prevention
Stroke Risk Factors: An Overview	17	(26)
Ralph L. Sacco
Alcohol and Stroke	43	(22)
Jean-Marc Orgogozo
Serge Renaud
Lipids and Stroke	65	(28)
E. John Nasrallah
Harold P. Adams, Jr
Hypertension	93	(14)
Philip A. Wolf
Atrial Fibrillation	107	(10)
David Sherman
Prevention and Screening Programs	117	(20)
Philip B. Gorelick
Hormones and Stroke Prevention	137	(24)
Diana B. Petitti
II Secondary Prevention
Cardiac Anomalies	161	(16)
G. Devuyst
J. Bogousslavsky
Acetylsalicyclic Acid (Aspirin)	177	(18)
Natan M. Bornstein
Antiplatelet Therapy	195	(16)
J. Donald Easton
Surgical Measures to Prevent Stroke	211	(26)
H. J. M. Barnett
Heather E. Meldrum
Angioplasty and Stenting	237	(22)
Martin M. Brown
III Prevention: Policy and Practice
Stroke Prevention: A Global Perspective	259	(16)
Ruth Bonita
From Clinical Trials to Clinical Practice	275	(20)
Geoffrey A. Donnan
The Appropriateness and Effectiveness of Stroke Prevention	295	(18)
Thomas E. Feasby
Policy and Practice in the Prevention of Stroke: Between the Ideal and the Affordable	313	(22)
Graeme J. Hankey
Epilogue	335	(6)
John W. Norris
Vladimir Hachinski
Index	341