Polypill strategy vs. prevention clinics for stroke prevention.
Thirty years of clinical trials have demonstrated that stroke can be prevented by reducing blood pressure to less than 140/90 mm Hg or by a further decrease of 10/5 mm Hg when blood pressure is controlled, by reducing LDL cholesterol by at least 1 mmol/l (39 mg/dl), and by inhibiting platelet aggregation. The (too simplistic) concept of the polypill strategy combining pharmacologic agents to achieve these goals is supposed to reduce the risk by 80% overall. However, reducing general salt and sugar intake, giving up smoking, developing prevention clinics with prevention nurses to improve adherence to preventive treatments, as well as decreasing poverty and malnutrition, increasing the level of hygiene, fighting against infectious diseases and financially helping developing countries are all combined necessary approaches to decrease the worldwide burden of stroke and other vascular diseases.
Department of Neurology and Stroke Center, Bichat Hospital, Denis Diderot University and Medical School, Paris, France. pierre.amarenco@bch.ap-hop-paris.fr
Pierre
P
Amarenco
D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D010353:Patient Education as Topic; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011314:Preventive Health Services / Q000639:trends; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000517:prevention & control*
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors