Regional differences in incidence and management of stroke - is there any difference between Western and Japanese guidelines on antiplatelet therapy?
OBJECTIVE
There have not been many discussions on the differences between the guidelines for the management of stroke used in eastern and western countries. The purpose of this paper was to examine whether or not there are substantial differences between western countries and Japan in the prevalence of stroke and the frequencies of stroke subtypes, as well as in the recommended therapy for secondary prevention of ischemic stroke.


CONCLUSIONS
Although there are racial differences and differences in approved drugs between the East and West, the prevalence of stroke and the frequencies of stroke subtypes tend to converge throughout the world. However, the ratio of stroke to ischemic heart disease is still different between the East and West. Comparison of various countries' guidelines shows that recommendations on antiplatelet therapy for secondary prevention of ischemic stroke are fundamentally similar in the East and West, but the recommended doses of antiplatelets, especially aspirin and ticlopidine, are smaller in Japan. Furthermore, Japanese guidelines only recommend the use of antiplatelets (particularly cilostazol) for patients with lacunar infarction with evidence.
Center for Stroke and Neurological Diseases, Tokai University, Tokyo Hospital, Tokyo, Japan. yshinoha@is.icc.u-tokai.ac.jp
Yukito
Y
Shinohara
D001241:Aspirin / Q000627:therapeutic use; D020520:Brain Infarction / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D000077407:Cilostazol; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D020521:Stroke / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D013777:Tetrazoles / Q000627:therapeutic use; D019366:Western World
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol; D001241:Aspirin