Handbook Of Stroke Prevention In Clinical Practice (current Clinical Neurology)

Although the strategies for stroke prevention are scientifically validated and widely accepted, they are often not effectively implemented, and the incidence of stroke has not decreased significantly. In Handbook of Stroke Prevention in Clinical Practice, leading physicians bring together all the up-to-date resources that a physician needs everyday in the office to assess and treat patients at high risk of stroke. The authors isolate the individual areas where intervention can help reduce stroke risk, providing not only background data on the major risk factors (hypertension, lipids, diabetes, tobacco, and alcohol)-along with the epidemiological and clinical trials data available to support the proposed intervention-but also practical advice on such lifestyle issues as diet, vitamin use, and exercise. Among the therapies fully discussed are lipid management, antithrombotic therapy, hormonal therapy, stenting, and angioplasty. Many of the basic tools necessary to measure risk and counsel patients are also provided, along with informative discussions of the less common causes of stroke, perioperative stroke risk assessment and management, the possibilities for early detection using novel biomarkers, and genetic susceptibility to stroke. Comprehensive and state-of-the-art, Handbook of Stroke Prevention in Clinical Practice is a concise survey of stroke and stroke prevention that offers busy physicians the practical resources needed to assess patients at high risk of stroke, determine optimal stroke prevention and management strategies, and successfully explain them to patients and their families. Despite major advances in the understanding of stroke mechanisms that have occurred over the past quarter century, stroke continues to rank among the leading causes of death and disability worldwide. Although currently it may be difficult to believe, early doubts were expressed as to whether inter­ ventions in risk factors for either coronary disease or stroke would actually lead to a reduction in the incidence of these disorders. However, large clini­ cal trials in hypertension, carotid disease, atrial fibrillation, and antithrombotic and antiplatelet therapies have effectively demonstrated the efficacy of these targeted interventions in reducing stroke incidence. More recently, after earlier uncertainty regarding the role of elevated lipids as a risk factor for stroke, clinical trials of the statins have also demonstrated a significant reduction in the incidence of ischemic stroke. However, as em­ phasized in Handbook of Stroke Prevention in Clinical Practice, despite these gains and the initial decline in stroke incidence that did occur in the 1960s and 1970s, the incidence of stroke disappointingly has failed to show a fur­ ther significant decline since that time. The editors of Handbook of Stroke Prevention in Clinical Practice raise the very important question of whether recognized strategies for stroke preven­ tion have been widely or effectively implemented. They correctly empha­ size the critical importance of identifying the mechanism of stroke in each patient so as to properly direct prevention and treatment. As Dr. Front Matter....Pages i-xiii Epidemiology of Stroke....Pages 1-18 Subtypes of Ischemic Stroke....Pages 19-33 Hypertension As a Risk Factor for Stroke....Pages 35-50 Evaluation and Management of Hyperlipidemia for Stroke Prevention....Pages 51-78 Diabetes....Pages 79-86 Tobacco and Alcohol....Pages 87-103 Diet, Obesity, and Physical Activity....Pages 105-115 Stroke Prevention With Antiplatelet Therapy....Pages 117-137 Hormonal Therapy....Pages 139-149 Stroke Due to Large Artery Atherosclerosis....Pages 151-165 Craniocervical Endovascular Stenting and Angioplasty....Pages 167-185 Cardiac Embolism....Pages 187-198 Cryptogenic Emboli and Other Elusive Causes of Stroke....Pages 199-225 Less Common Causes of Ischemic Stroke....Pages 227-242 Perioperative Stroke Risk Assessment and Management....Pages 243-256 Serum Biomarkers in Prediction of Stroke Risk and Outcome....Pages 257-278 Genetic Susceptibility and Early Stratification of Stroke Risk....Pages 279-301 Back Matter....Pages 303-310 Provides information for physicians for assessing and treating patients at high risk of stroke. Introduces areas where intervention can help reduce risk and covers lifestyle issues, such as diet, vitamin use, and exercise.