University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

103

Pages:

2
Author:

Mariam A.

Secondary prevention of stroke      A: antiplatelet (aspirin, clopidogrel, extended-release dipyridamole, ticlopidine) and anticoagulants (warfarin, dabagatran, rivaroxaban, apixaban). o Patients with non-cardioembolic stroke or TIA should start antiplatelet agents rather than anticoagulants. Uncertain which antiplatelet to use. o Anticoagulation for atrial fibrillation (advantageous to use dabagatran, rivaroxaban and apixaban over warfarin because they do not need monitoring). B: blood pressure-lowering medications. C: cessation of cigarette smoking, cholesterol-lowering medications, carotid revascularisation. o Statins reduce cholesterol and might relate to pleiotropic effects; therapeutic effect not necessarily linked to LDL reduction. D: diet. E: exercise. Stroke units  73 stroke units in Australia; 50% of stroke patients receive stroke unit care.  Health professionals in the unit have ample training and experience in stroke management to provide care for acute stroke patients.  Shown to improve a patient’s chance of recovery and independent living. Allied health  Physiotherapy.  Speech pathology.  Dietician.  Occupational therapy. Non-modifiable risk factors  Age: o Risk of stroke increases with age. o With each successive decade after 55, the risk of stroke doubles. o In Australia, majority of strokes occur in people aged >65 years old.  Sex: o Females > males; largely because there are more women that are elderly in the population.   o However, age-standardised incidence rate is 30% higher for men, with men tending to suffer stroke at a younger age. Ethnicity: o Incidence, subtype and outcome of stroke vary between ethnic groups. o Stroke affects Indigenous people at a younger age (mean: 45 – 64) compared with non-Indigenous Australians (mostly >65). Familial/genetics: o Maternal and paternal history of stroke may increase the risk of stroke in individuals. o Small genetic contribution to stroke. Modifiable risk factors  TIA: o Warning a future stroke may be imminent. o Early identification of symptoms and treatment by doctor greatly reduces the chance of a major stroke.  Hypertension: o Most important risk factor for stroke. o High BP can result in damage to blood vessels, eventually leading to a stroke.  Cigarette smoking: o Increase risk of stroke by increasing BP and reducing oxygen in blood.  High cholesterol: o Important risk factor contributing to blood vessel disease, and ultimately, stroke.  Poor diet and lack of exercise: o Being inactive, overweight, or both, can increase risk of high BP, high cholesterol, diabetes, heart disease and stroke.  Obesity, diabetes, alcohol.  Atrial fibrillation.