The major treatable risk factors for cerebrovascular atherosclerotic disease and stroke (CVA) are similar to those for CAD.
- Hypertension
- Diabetes
- Smoking
- Dyslipidemia (abnormal cholesterol levels)
The risk is particularly increased in patients with two or more of these risk factors.Control of risk factors for CAD also reduces the risk of stroke.
Hypertension
The risk of both stroke and coronary disease increase as the blood pressure rises above 110/75. Reducing the blood pressure in hypertensive patients, even those with mild hypertension, lowers the risk of stroke. The target blood pressure in this setting is not well defined, and should be individualized.A goal of <130/80 mmHg seems reasonable for most patients.
Current data have shown a benefit of the combination of a diuretic with an ACE inhibitor for reduction of stroke recurrence.
SMOKING
Cigarette smoking is associated with an increased risk for stroke.Smokers have a relative risk of stroke of 2.58 compared with those who never smoke.Evaluation of former smokers found that the excess risk disappeared within two to four years.
DIABETES
Patients with diabetes mellitus have approximately twice the risk of ischemic stroke compared with those without diabetes. Strict diabetes control reduces the risk of vascular complications (eg, your eyes, kidneys, and brain & nerves).
Metabolic syndrome
Metabolic syndrome (a combination of Hypertension, Dyslipidemia (abnormal cholesterol levels), central obesity and Diabetes) is a risk factor for stroke and CAD.
Abnormal cholesterol levels
Hyperlipidemia is a major risk factor for CAD as well as Carotid artery disease and stroke related to complications of Carotid disease.The American Heart Association/American Stroke Association (AHA/ASA) and the National Stroke Association have published guidelines for the prevention of stroke in patients with ischemic stroke risk factors.
- Blood pressure reduction
- Glucose control
- Cholesterol and statin therapy with a target LDL goal of <100 mg/dL and HDL cholesterol (>40 mg/dL)