American Society of Hypertension Self-Assessment GuideTreatment: special conditions: Co-existing vascular disease: stroke
Introduction
In this section of the ASH Hypertension Self–Assessment Manual on target organ damage related to hypertension, we review three topics: (1) primary prevention of stroke; (2) acute stroke treatment and diagnosis; and (3) recurrent stroke prevention.1 Our discussion will explore evidence–based guideline management options for blood pressure control in stroke prevention and treatment as well as other important topics that hypertension specialists should master in relation to stroke.
Section snippets
Overview
The INTERSTROKE Study identified 10 factors that were associated with 90% of stroke risk. These factors, many of which are shared risks for coronary heart disease, include hypertension, current smoking, waist:hip ratio, diet risk score, physical inactivity, diabetes mellitus, alcohol consumption (>30 drinks/month or binge drinking), psychosocial stress and depression, cardiac causes, and the ratio of apolipoprotein B to A1.2 Of these factors, hypertension has the highest population attributable
Overview
Annually, there are about 795,000 strokes in the US.1 Almost 75% of strokes are first strokes, and the remainder of strokes are recurrent ones. The emergence of intravenous thrombolytic therapy (alteplase) and intra–arterial neurothombectomy devices has substantially heightened our armamentarium for the treatment of acute ischemic stroke (AIS).11 The treatment of AIS has evolved over time in conjunction with organized systems of stroke care such as The Joint Commission (TJC)–certified primary
Overview
Recurrent stroke is an important public health challenge. There are almost 200,000 recurrent ischemic strokes annually in the US, and the risk of recurrent stroke over a 5–year period may be as high as 30% or more.1 Transient ischemic attack (TIA) as a warning sign of stroke represents part of the continuum of ischemic stroke and is a risk for ischemic stroke, especially soon after TIA. TIA has traditionally been defined as a transient (<24 hours time), focal, neurological deficit due to
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This article is part of the American Society of Hypertension Self-Assessment Guide series. For other articles in this series, visit the JASH home page at www.ashjournal.com.