[Stroke prevention]

Abstract

Life style modification has been shown to reduce stroke risk. In patients with risk factors several drugs have proven their efficacy. The most effective medications are antihypertensives, antidiabetics, statins and antithrombotics. In the prevention of recurrent stroke in patients with a noncardioembolic ischemic stroke antiplatelet agents are used. Aspirin or a combination aspirin/dipyridamol are the first-line agents. Clopidogrel is recommended for patients with aspirin intolerance, several risk factors or recurrent cerebrovascular events. Warfarin has demonstrated efficacy in stroke prevention in patients with cardioembolic stroke, cerebral venous thrombosis and antiphospholipid antibody syndrome. Other, less well established indications for warfarin in the secondary prevention of stroke are: symptomatic intracranial artery stenosis; large aortic atheroma and extracranial carotid or vertebral artery dissection.