What is secondary prevention of ischemic stroke?

Updated: May 27, 2020
  • Author: Edward C Jauch, MD, MS, FAHA, FACEP; Chief Editor: Helmi L Lutsep, MD  more...
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Secondary prevention refers to the treatment of individuals who have already had a stroke. Measures may include the use of anitplatelet agents, [126] anticoagulants (warfarin or newer novel oral anticoagulants) antihypertensives, statins, [127] and lifestyle interventions. A study by the Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators concluded that in stroke patients who have significant intracranial arterial stenosis, aspirin should be used in preference to warfarin for secondary prevention. [128]

Smoking cessation, blood pressure control, diabetes control, a low-fat low-salt diet, weight loss, and regular exercise should be encouraged as strongly as the medications described above. The 2011 AHA/ASA guidelines recommend ED-based smoking cessation interventions, and consider it reasonable for EDs to screen patients for hypertension and drug abuse. [22]

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