Stroke prophylaxis: hypertension management and antithrombotic therapy.
OBJECTIVE
To review trials involving risk factor management and pharmacologic therapy for the prevention of stroke.


METHODS
English-language literature published between 1966 and 1992 was analyzed; pertinent literature is reviewed.


METHODS
Studies that evaluated the impact of risk factor management on prevention of vascular events were selected. In addition, trials assessing the safety and efficacy of pharmacologic intervention in primary and secondary stroke prevention were evaluated.


METHODS
Trials were evaluated for their ability to demonstrate a decrease in stroke occurrence.


RESULTS
Various trials were analyzed in several categories. Studies evaluating risk factor management of hypertension and cardiogenic cerebral emboli were reviewed and recommendations made based on a consensus of these trials. The use of antiplatelet agents in stroke prevention was addressed by a review of pertinent trials and meta-analyses.


CONCLUSIONS
The control of risk factors and the use of antiplatelet agents significantly reduces the risk of vascular events. Benefit from different therapies may be specific to certain patient populations and recommendations are made for these patients.
Tortorice
K L
KL
Department of Neurology and Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago.
Carter
B L
BL
D000925:Anticoagulants / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000517:prevention & control*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors