[Drug therapy in secondary prophylaxis after transient cerebral ischemia or cerebral infarction].
BACKGROUND
Stroke is the third leading cause of death in western countries and the leading cause of dependence in activities of daily living. Efforts to reduce its prevalence should therefore be given the highest priority. Uncertainty prevails as to the significance of the various types of intervention.


METHODS
This review is based on personal experience, though mostly on a search for relevant literature in the Cochrane Library.


RESULTS
Important measures are treatment of hypertension with target area 140/90 mm Hg, anticoagulation in patients with atrial fibrillation and other potential sources of cardioemboli, and for the remainder antiplatelet agents in the form of acetylsalicylic acid, probably preferably combined with dipyradimole. One should also consider drugs reducing serum lipids.


CONCLUSIONS
Adequate secondary prophylaxis after transient ischaemic attack (TIA) or ischaemic stroke is of potential great benefit in reducing the incidence of new stroke, myocardial infarction or premature vascular death. Standardised guidelines may facilitate implementation of these measures, if they are regularly updated and adjusted to the needs of the individual patient.
Salvesen
Rolf
R
Nevrologisk avdeling, Nordlandssykehuset, 8092 Bodø. rolf.salvesen@nlsh.no
D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011379:Prognosis; D020521:Stroke / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*
D000924:Anticholesteremic Agents; D000925:Anticoagulants; D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors