Ischemic and hemorrhagic strokes are among the principal causesof death and disability in older people, although the incidenceof such strokes is lower than in the past.1,2 Control of bloodpressure, decreased cigarette smoking, and possibly altereddietary habits are among the important but unconfirmed reasonsproposed for this decline.3,4,5 This review addresses the antithromboticand surgical measures to prevent ischemic stroke that have beenrigorously evaluated in randomized clinical trials.
Use of Anticoagulant Agents to Prevent Ischemic Stroke
Since the introduction of anticoagulant agents 50 years ago,their use has varied widely, which is to be expected for a treatmentbased on anecdotal evidence, case studies, . . . [Full Text of this Article]
Cardiac Disorders
Arteriosclerotic Lesions of the Cerebral Arteries
Prevention of Ischemic Stroke with Platelet Inhibitors
Clinical Trials of Platelet-Inhibiting Drugs
Meta-Analyses of Trials of Platelet-Inhibiting Drugs
Ticlopidine
Aspirin in Healthy Middle-Aged Subjects
Recommendations for Administering Platelet Inhibitors
Surgical Procedures to Prevent Stroke
Carotid Endarterectomy
Symptomatic Carotid Artery Disease
Ultrasonography as a Prelude to Carotid Endarterectomy
Asymptomatic Carotid Artery Disease
Asymptomatic Carotid-Artery Stenosis and Coronary-Artery Bypass Surgery
Symptomatic Carotid-Artery Stenosis and Coronary-Artery Bypass Surgery
Extracranial-to-Intracranial Anastomosis
Percutaneous Transluminal Angioplasty for Cerebral-Artery Stenosis
Summary
Source Information
From the Departments of Clinical Neurological Sciences (H.J.M.B.) and Epidemiology and Biostatistics (M.E.), University of Western Ontario, and the John P. Robarts Research Institute (H.J.M.B., M.E., H.E.M.), both in London, Ont., Canada.
Address reprint requests to Dr. Barnett at the Robarts Research Institute, 100 Perth Dr., P.O. Box 5015, London, ON N6A 5K8, Canada.
Primary Prevention of Stroke
Martinez-Riera A., Santolaria-Fernandez F., Gonzalez-Reimers E., Perry I. J., Gilbert R.E., Jerums G., Cooper M.E., Bronner L. L., Kanter D. S., Manson J. E.
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N Engl J Med 1996;
334:1138-1139, Apr 25, 1996.
Correspondence
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