Sunday, May 07, 2006

For Your Health

Experts Issue New Stroke-Prevention Guidelines

For Patients:
Have regular screenings for high blood pressure -- at least every two years in adults and more frequently in minorities and the elderly -- and keep blood pressure under control.
Don't smoke, and eliminate exposure to secondhand smoke.
If you have diabetes, maintain tight control of blood pressure. If you have diabetes and other stroke risk factors, talk to your doctor about taking a cholesterol-lowering statin drug.
Reduce your intake of salt (no more than 2.3 grams of sodium a day), and increase your intake of potassium (at least 4.7 grams a day) in order to lower high blood pressure. Eat a diet high in fruit, vegetables, low-fat dairy products and low in saturated and total fat.
Lower total cholesterol to acceptable levels.
Lose weight, which can lower blood pressure.
Get moderately intensive physical activity for a least 30 minutes a day.
For Doctors:
Treat cardiovascular diseases that increase stroke risk such as coronary heart disease, heart failure and peripheral artery disease.
Consider clot-preventing anticoagulants or antithrombotics for high-risk patients with atrial fibrillation.
Consider statins for patients with diabetes and other stroke risk factors.
For patients with severe blockage of the carotid artery in the neck without symptoms, consider recommending preventive carotid endarectomy surgery by a surgeon with a low complication rate.
Beginning at age 2, use transcranial Doppler ultrasound to screen children with sickle cell disease and consider transfusion therapy for those with an elevated risk of stroke.
Evaluate adult sickle cell patients for stroke risk factors and manage those risk factors according to the general guidelines in this new stroke prevention statement.
Do not prescribe hormone therapy (with estrogen, with or without progestin) for primary stroke prevention.

The guidelines also include suggestions on other measures that may reduce stroke risk.
For Patients:
Alcohol intake should be limited to no more than two drinks a day for men and one drink a day for nonpregnant women.
Don't use illicit drugs.
Women who smoke or have a history of blood clots should not take oral contraceptives.
If you notice signs of sleep-disordered breathing (loud snoring, excessive daytime sleepiness, repeatedly gasping for air during sleep), go to a specialist to be evaluated.
For Doctors:
Treat the components of metabolic syndrome -- abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, insulin resistance.
Consider low-dose aspirin therapy for women at high risk of stroke.

No comments: