PEVENTING A STROKE Flashcards
(28 cards)
what is primary prevention?
avoiding a disease before any signs or symptoms develop
what is secondaryy prevention?
avoidance of progression or later problems by treating the person who has had a stroke or TIA
what are some non-modifiable risk factors for stroke?
age >55 gender woman race - black idnividuals genetics/family history personal history
what are some modifiable risk factors of stroke?
hypertension diabetes atrial fibrillation smoking hyperlipidaemia obesity oral contraceptive sickle cell disease migraines with aura
what is primary prevention of a stroke?
lifestyle modifications and measures to control blood pressure, cholesterol levels, diabetes mellitus, and atrial fibrillation.
why is hypertension the biggest risk factor for stroke?
hypertension increases risk of damage to vessels as well as accelerating atherosclerosis
why is diabetes a risk factor for stroke?
Over time, high glucose levels can damage the body’s blood vessels, increasing the chance of stroke
why is atrial fibrillation a risk factor for stroke?
rapid heartbeat allows blood to pool in the heart, which can cause clots to form and travel to the brain
why is smoking a risk factor for stroke?
Carbon monoxide reduces the amount of oxygen in your blood, and the nicotine makes your heart beat faster and raises your blood pressure. It can also trigger an episode of atrial fibrillation
why is hyperlipiademia a risk factor for stroke?
cholesterol deposits in arteries, narrowing them
why is the oral contraceptive pill a stroke risk factor?
It raises blood pressure and makes blood hypercoagulable
what are some common reasons for young people to have strokes?
dissection of artery cardioembolism e.g. from PFO endocarditis vasculitis genetic causes illicit drug use clotting disorders
which illicit drugs are commonly associated with stroke?
cocaine and amphetamine - causes hypertension surges
how much does smoking >20 a day increase risk of stroke?
4 times
how many stroke victims will have another stroke within 3 months?
1/5 (your risk is 15 times higher than a healthy individual)
what is the CHADS2 score?
Its an assessment tool for estimating stroke risk in patients with AF
it asks about congestive heart failure history, hypertension history, >75, Dm history, previous stroke/TIA- all worth 1 point other than the last which is worth 2 points
(score of >3 is high risk)
outline the secondary prevention a doctor prescribes after stroke in terms of lifestyle?
minimise sitting for long periods
individualized exercise programmes
advise to stop smoking
eat a healthy balanced diet
keep alcohol consumption within recommended limits
advise against routine dietary supplementation with B vitamins/folate, vits A, C E, selenium, calcium, vit D
what antiplatelet medications are used in secondary prevention of a stroke?
clopidogrel daily
if this cant be tolerated then aspirin with modified release dipyridamole
aspirin can be used alone if the dipyridamole isnt tolerated
when is dual antiplatelet therapy used and what is used?
people at high risk of TIA (e.g. ABCD2 score >4) or those with intercranial stenosis
aspirin plus clopidogrel or aspirin plus ticagrelor
what is an ABCD2 score?
an assessment tool for estimating the risk of stroke after a susepected TIA
what does the ABCD2 score measure?
age >60 bp >140/90 whether there was unliateral weakness or speech distubance duration of symptoms history of diabetes
what lipid modification drug is usually given after a stroke?
statins e.g. atorvostatin
who should statin treatment be contradicted in?
primary intracerebral haemorrhage
whats a common complaint of statins?
myalgia - muscle pain
